血清吲哚胺2,3-双加氧酶和犬尿喹啉酸在支气管肺发育不良早产儿中的变化  

Changes in serum indoleamine 2,3-dioxygenase and kynurenic acid levels in preterm infants with bronchopulmonary dysplasia

作　　者：陈慧娟 孙文强 李梦曌 杨紫浩 朱雪萍[1] Chen Huijuan;Sun Wenqiang;Li Mengzhao;Yang Zihao;Zhu Xueping(Department of Neonatology,Children's Hospital of Soochow University,Suzhou 215025,China)

机构地区：[1]苏州大学附属儿童医院新生儿科,苏州215025

出　　处：《中华围产医学杂志》2024年第3期215-219,共5页Chinese Journal of Perinatal Medicine

基　　金：国家自然科学基金(81971423,82271741);江苏省卫生健康委员会医学科研课题重点项目(ZD2021013);江苏省重点研发计划(社会发展项目)(BE2020658);姑苏领军人才(GSWS2022055);临床科技高端平台和转化基地建设项目(ML13101523);苏州大学附属儿童医院“遂园”临床研究项目(SY003)。

摘　　要：目的探讨血清吲哚胺2,3-双加氧酶(indoleamine 2,3-dioxygenase,IDO)及犬尿喹啉酸(kynurenic acid,KYNA)在支气管肺发育不良(bronchopulmonary dysplasia,BPD)早产儿中的变化。方法采用巢式病例对照研究。建立早产儿队列,纳入2021年12月1日至2022年12月31日生后24 h内收住苏州大学附属儿童医院新生儿科的胎龄<32周的早产儿。诊断BPD者作为BPD组(n=35),按1∶1比例选取与BPD组胎龄相差<1周、出生体重相差<150 g的非BPD早产儿作为对照组(n=35)。检测患儿生后第1、7、14、28天血清IDO及KYNA水平。分析BPD组与对照组间、轻度BPD与中-重度BPD患儿间血清IDO及KYNA水平的差异,以及血清IDO及KYNA水平与BPD严重程度的关系。采用两独立样本t检验和Spearman相关分析进行统计学分析。结果与对照组患儿相比,BPD组患儿生后第7、14、28天血清IDO水平[分别为(60.68±9.37)与(50.66±10.46)、(57.81±11.07)与(44.45±8.20)、(50.62±10.77)与(41.31±7.74)pg/ml,t值分别为4.21、5.73和4.15]及第14、28天血清KYNA水平均升高[(439.31±41.22)与(368.99±68.79)、(376.97±45.74)与(325.50±60.07)μmol/L,t值分别为5.18和4.03],差异均有统计学意义(P值均<0.05)。生后第7、14、28天血清IDO水平与BPD严重程度均呈正相关(r值分别为0.546、0.495和0.502,P值均<0.05),生后第14、28天血清KYNA水平与BPD严重程度也呈正相关(r值分别为0.536和0.458,P值均<0.05)。结论BPD患儿血清IDO及KYNA水平升高,提示IDO和KYNA可能在BPD发生和发展中发挥一定作用。Objective To explore the changes in serum indoleamine 2,3-dioxygenase(IDO)and kynurenic acid(KYNA)levels in preterm infants diagnosed with bronchopulmonary dysplasia(BPD).Methods A nested case-control study was conducted.The inclusion criteria covered premature infants with less than 32 weeks of gestational age within 24 h post-birth,from December 1,2021,to December 31,2022,at Children's Hospital of Soochow University.Those diagnosed with BPD were allocated to the BPD group(n=35).Non-BPD preterm infants matching the BPD cases in terms of gestational age(within one week difference)and birth weight(within a 150 g difference)were selected in a 1∶1 ratio for the control group(n=35).Serum levels of IDO and KYNA were measured on days 1,7,14,and 28 postnatally.Differences in serum IDO and KYNA levels were analyzed between the BPD and control groups and among infants with mild BPD versus moderate-to-severe BPD.The association between serum IDO and KYNA levels with the severity of BPD was also assessed.Statistical analysis was conducted using independent samples t-tests and Spearman's correlation analysis.Results Elevated levels of serum IDO on days 7,14,and 28 postnatally[(60.68±9.37)vs.(50.66±10.46),(57.81±11.07)vs.(44.45±8.20),and(50.62±10.77)vs.(41.31±7.74)pg/ml;t=4.21,5.73,and 4.15,respectively]as well as increased serum KYNA levels on days 14 and 28[(439.31±41.22)vs.(368.99±68.79),(376.97±45.74)vs.(325.50±60.07)μmol/L;t=5.18 and 4.03,respectively]were observed in the BPD group compared to the control group,with all differences being statistically significant(all P<0.05).Furthermore,positive correlations were observed between serum IDO levels and BPD severity on the 7th,14th,and 28th days(r=0.546,0.495,and 0.502,all P<0.05),as well as between serum KYNA levels and BPD severity on the 14th and 28th days(r=0.536 and 0.458,both P<0.05).Conclusion Elevated serum levels of IDO and KYNA in infants with BPD suggest these metabolites may play a role in the pathogenesis and progression of BPD.

关 键 词：支气管肺发育不良 色氨酸 吲哚胺2 3-双加氧酶 犬尿喹啉酸 

分 类 号：R722.6[医药卫生—儿科]