| 摘要: |
| 目的 探讨母亲胎盘炎症与宫内感染早产儿血清白细胞介素6(IL-6)的相关性,母亲产前抗生素使用对宫内感染早产儿血清IL-6水平的影响,以及血清IL-6水平变化与早产儿出生后相关感染性疾病的发生和近期预后的关系。方法 选取2019年1月至2019年12月在雅安市人民医院产科分娩,胎龄28~36周、单活胎、转入该院新生儿科、符合宫内感染诊断标准而母亲无其他合并症的早产儿为研究对象,将其胎膜胎盘送病理检查,并检测出生时、治疗48 h后早产儿血清IL-6的水平。首先,将宫内感染早产儿根据胎盘病检结果分为无绒毛膜羊膜炎组、绒毛膜羊膜炎Ⅰ期组、绒毛膜羊膜炎Ⅱ期组,探讨母亲胎盘炎症与宫内感染早产儿血清IL-6水平的关系;其次,将宫内感染早产儿按母亲产前使用抗生素疗程分为母亲产前使用抗生素≥3 d组、<3 d组及未使用组,探讨母亲产前抗生素使用对宫内感染早产儿血清IL-6水平的影响;最后,将宫内感染早产儿分别根据其胎龄、病情、IL-6水平及治疗48 h后转归进行分组,比较各组IL-6水平及相关疾病的发生率。结果 绒毛膜羊膜炎组早产儿出生时血清 IL-6 水平高于无绒毛膜羊膜炎组,且在无绒毛膜羊膜炎、绒毛膜羊膜炎Ⅰ期、Ⅱ期的病例中呈依次递增趋势,差异有统计学意义(P<0.05);母亲产前使用抗生素(≥3 d、<3 d)早产儿出生时血清 IL-6 水平均低于未使用病例,差异有统计学意义(P<0.05);不同胎龄早产儿出生时血清 IL-6 水平之间比较,差异无统计学意义(P<0.05);早产儿出生时血清 IL-6 水平在非危重组、危重组及极危重组呈上升趋势,但三组之间差异无统计学意义(P<0.05);病情好转组治疗48 h后血清 IL-6 水平低于出生时,病情加重组治疗 48 h 后血清 IL-6 水平高于出生时,差异有统计学意义(P<0.05);IL-6>7 pg/ml 与≤7 pg/ml 早产儿 PVL、PIVH、ROP、BPD 的发生率差异无统计学意义(P<0.05)。结论 宫内感染时早产儿静脉血 IL-6 水平升高,且与胎盘炎症严重程度相关;母亲产前应用抗生素能有效降低宫内感染早产儿血清 IL-6 水平,且血清 IL-6 水平与临床治疗效果相关;而宫内感染早产儿出生时 IL-6 水平和 PVL、PIVH、ROP、BPD的发生率没有必然联系,故血清 IL-6 水平对评价感染严重程度、指导抗生素应用、评估疗效具有一定的参考意义。 |
| 关键词: 白细胞介素6 早产儿 宫内感染 胎盘炎症 近期预后 |
| DOI：10.16252/j.cnki.issn1004-0501-2021.01.017 |
| 分类号:R446.11 |
| 文章编号:1004-0501(2021)01-0072-06 |
| 文献标识码:A |
| 基金项目: |
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| IL-6 Detection in the Treatment of Premature Infants with Intrauterine Infection. |
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Chen Wei1, Zou Yongrong1, Gao Yue1, Lu Liqun2
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1.Department of Neonatology,Ya-an People′s Hospital, Yaan,Sichuan 625000 ,China;2.Department of Pediatrics, First Affiliated Hospital of Chengdu Medical College, Chengdu 610500 , China
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| Abstract: |
| Objective To investigate relationship between maternal placental inflammation and serum interleukin 6(IL-6)of preterm infants with intrauterine infection, effect of maternal prenatal antibiotics on serum IL-6, and relationship between serum IL-6 changes and related infectious diseases. Methods From January 2019 to December 2019, preterm infants with 28~36 weeks gestational age were selected who transferred to neonatal department, met diagnostic criteria for intrauterine infection in obstetrics department of Ya-an people-s hospital. Moreover, they were single live birth and their mother has no other complications. Their fetal membranes and placenta were sent for pathological examination, and serum IL-6 was detected at birth and 48h after treatment. Firstly, according to placental disease examination, preterm infants with intrauterine infection were divided into no chorioamnionitis group, chorioamnionitis stage Ⅰ group, chorioamnionitis stage Ⅱ group. Relationship between maternal placental inflammation and IL-6 was explored. Secondly, according to mother-s prenatal antibiotic treatment, preterm infants were divided into mother-s prenatal antibiotics ≥3 d,<3 d and non-used group. Effect of mother-s prenatal antibiotic on IL-6 was explored. Finally, preterm infants were divided into groups according to their gestational age, condition, IL-6 and outcome after 48 hours of treatment, IL-6 and related diseases were compared. Results IL-6 at birth in chorioamnionitis group was higher than that in no chorioamnionitis group, and a sequential increase trend was showed among three groups with statistically significant difference(P<0.05). IL-6 in mother-s prenatal use of antibiotics(≥3 d,<3 d)group at birth were lower than unused cases with statistically significant difference(P<0.05). There was no significant difference in IL-6 at different gestational ages(P<0.05). IL-6 at birth increased in non-dangerous, critical and critically critical groups without statistically significant difference(P<0.05). IL-6 at 48h after treatment of improved group was lower than that at birth, and IL-6 at 48h after treatment of severe group was higher than that at birth(P<0.05). There was no statistically significant difference in PVL, PIVH, ROP and BPD between IL-6>7 pg/ml and≤7 pg/ml(P<0.05). Conclusion IL-6 of preterm infants would increase during intrauterine infection that is related to placental inflammation severity. Prenatal antibiotics could effectively reduce IL-6 that is related to clinical treatment effect. IL-6 at birth could not be necessarily related to PVL, PIVH, ROP, and BPD. Therefore, IL-6 is useful for evaluating infection severity, guiding antibiotics application, and evaluating efficacy. |
| Key words: interleukin-6 preterm infants intrauterine infection placental inflammation short-term prognosis |
