MIF和MMP-9水平及胎膜早破病史与极早产儿支气管肺发育不良的关系  

Relationship between MIF and MMP-9 levels combined with premature rupture of membranes and bronchopulmonary dysplasia in very preterm infants

作　　者：范旭方 张樱彦 张文果 夏磊[1] 吕荣吉 赵家文 FAN Xu-fang;ZHANG Ying-yan;ZHANG Wen-guo;XIA Lei;LYU Rong-ji;ZHAO Jia-wen(Department of Neonatology,the Third Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China)

机构地区：[1]郑州大学第三附属医院新生儿科,郑州450052

出　　处：《医药论坛杂志》2025年第2期148-152,共5页Journal of Medical Forum

摘　　要：目的 分通过检测血清巨噬细胞迁移抑制因子(macrophage migration inhibitory factor,MIF)、基质金属蛋白酶-9(matrix metalloproteinase-9,lMP-9)水平以及胎膜早破病史,探讨其与极早产儿支气管肺发育不良(bronchopulmonary dysplasia,BPD)的关系。方法 选取2021年6月至2022年5月郑州大学第三附属医院产科出生转至新生儿重症监护室(neonatal intensive care unit,NICU)的45例极早产儿(胎龄<32周),根据是否诊断BPD分为非BPD组(n=24)和BPD组(n=21)。采用酶联免疫吸附法检测血清MIF、MMP-9的水平,比较生后第7天两组血清MIF、MMP-9水平差异,联合母亲孕期胎膜早破病史,分析其对BPD诊断价值。结果 在血清MIF、MMP-9水平方面:BPD组高于非BPD组,差异均有统计学意义(P<0.05)。单因素分析提示两组在胎膜早破发生率、住院时长、总氧疗时长比较差异有统计学意义(P<0.05);进一步受试者工作特征(receiver operating characteristic,ROC)曲线结果显示,MIF、MMP-9胎膜早破单独检测诊断BPD时曲线下面积(area under the curve,AUC)分别为0.780、0.651、0.661,联合诊断为0.885,高于单独诊断。结论 血清MIF、MMP-9水平变化与极早产儿BPD发生存在相关性,联合母亲孕期胎膜早破病史,更有助于预测极早产儿BPD的发生。Objective To investigate the relationship between bronchopulmonary dysplasia(BPD)in extremely premature infants and the levels of serum macrophage migration inhibitory factor(MIF)and matrix metalloproteinase-9(MMP-9),as well as the history of premature rupture of membranes.Methods Forty-five very preterm infants(gestational age < 32 weeks) admitted to the neonatal intensive care unit of the Third Affiliated Hospital of Zhengzhou University from June 2021 to May 2022 were selected and divided into non-BPD group(n=24) and BPD group(n=21) according to whether they had BPD or not.Enzyme-linked immunosorbent assay(ELISA) was used to detect the expression levels of serum MIF and MMP-9.The levels of serum MIF and MMP-9 were compared between the non-BPD group and the BPD group on the 7th day after birth combined with maternal history of premature rupture of membranes during pregnancy,and their diagnostic value for BPD was analyzed.Results The serum levels of MIF and MMP-9 in BPD group were significantly higher than those in non-BPD group(P<0.05).Univariate analysis indicated that there were statistically significant differences between the two groups in the incidence of premature rupture of membranes,length of hospital stay,and total duration of oxygen therapy(P<0.05).Further results of the receiver operating characteristic(ROC)curve showed that the area under the curve(AUC)of MIF and MMP-9 in the diagnosis of BPD was 0.780,0.651 and 0.661 respectively,and the AUC of combined diagnosis was 0.885,which was higher than that of single diagnosis.Conclusion The changes of serum MIF and MMP-9 levels are related to the occurrence and development of BPD in very preterm infants.Combined with the history of premature rupture of membranes during mother's pregnancy,it is more helpful to predict the occurrence of BPD in very preterm infants.

关 键 词：巨噬细胞迁移抑制因子 基质金属蛋白酶-9 极早产儿 支气管肺发育不良 

分 类 号：R722.6[医药卫生—儿科]