CAJ | 학술논문

目的：研究宫内感染与早产儿脑损伤的因果关系，从细胞因子网络反应角度探讨宫内感染早产儿脑损伤机制，为防治早产儿脑损伤提供新途径。方法将100例早产儿根据头颅超声及 CT 检查结果分为早产脑损伤组（31例）和早产无脑损伤组（69例）。通过对2组胎膜、胎盘的病理检测（主要以检测绒毛膜羊膜炎为主），判断是否有宫内感染导致的早产儿脑损伤。采用酶联免疫吸附试验（ELISA）检测2组血清中细胞因子[IL-1β、IL-6、IL-10及肿瘤坏死因子（TNF-α）]的水平。结果100例患儿中发生宫内感染40例，60例为非宫内感染，宫内感染患病率为40．0％。宫内感染患儿脑损伤的患病率为47．5％（19／40），非宫内感染患儿脑损伤的患病率为20．0％（12／60）。宫内感染患儿脑损伤患病率显著高于非宫内感染患儿（χ2＝8．485，P ＜0．05）。早产脑损伤组 IL-1β、IL-6、IL-10及TNF-α分别为（6．33±2．17）（8．20±4．10）（1．46±0．25）及（5．35±2．00）μg·L－1；早产无脑损伤组 IL-1β、IL-6、IL-10及 TNF-α分别为（1．44±1．01）（1．58±2．33）（1．65±0．30）及（3．57±1．33）μg·L－1。早产脑损伤组 IL-1β、IL-6、TNF-α显著高于早产无脑损伤组，IL-10低于早产无脑损伤组（均 P ＜0．05）。结论早产儿脑损伤与宫内感染关系密切，细胞因子网络反应可能介导该损伤过程。
목적：연구궁내감염여조산인뇌손상적인과관계，종세포인자망락반응각도탐토궁내감염조산인뇌손상궤제，위방치조산인뇌손상제공신도경。방법장100례조산인근거두로초성급 CT 검사결과분위조산뇌손상조（31례）화조산무뇌손상조（69례）。통과대2조태막、태반적병리검측（주요이검측융모막양막염위주），판단시부유궁내감염도치적조산인뇌손상。채용매련면역흡부시험（ELISA）검측2조혈청중세포인자[IL-1β、IL-6、IL-10급종류배사인자（TNF-α）]적수평。결과100례환인중발생궁내감염40례，60례위비궁내감염，궁내감염환병솔위40．0％。궁내감염환인뇌손상적환병솔위47．5％（19／40），비궁내감염환인뇌손상적환병솔위20．0％（12／60）。궁내감염환인뇌손상환병솔현저고우비궁내감염환인（χ2＝8．485，P ＜0．05）。조산뇌손상조 IL-1β、IL-6、IL-10급TNF-α분별위（6．33±2．17）（8．20±4．10）（1．46±0．25）급（5．35±2．00）μg·L－1；조산무뇌손상조 IL-1β、IL-6、IL-10급 TNF-α분별위（1．44±1．01）（1．58±2．33）（1．65±0．30）급（3．57±1．33）μg·L－1。조산뇌손상조 IL-1β、IL-6、TNF-α현저고우조산무뇌손상조，IL-10저우조산무뇌손상조（균 P ＜0．05）。결론조산인뇌손상여궁내감염관계밀절，세포인자망락반응가능개도해손상과정。
ABSTRACT:Objective To explore the causality relationship between intrauterine infection and brain damage in premature infants,to observe the mechanism of brain damage in premature in-fants with intrauterine infection from the perspective of cytokine network response,and to provide a new way of preventing premature brain damage.Methods According to head ultrasound and CT results,100 premature infants were divided into brain damage group(n = 31)and non-brain damage group (n = 69 ).Intrauterine infection-induced premature brain damage was observed through pathological examinations of fetal membranes and placenta(mainly chorioamnionitis).In addition,serum levels of cytokines interleukin-1β(IL-1β),interleukin-6 (IL-6 ),interleukin-10 (IL-10)and tumor necrosis factor-α(TNF-α)were detected by ELISA.Results The prevalence of intrauterine infection was 40.0%(40/100).The incidence of brain damage in infants with intrau-terine infection(47.5%,19/40)was significantly higher than that in infants without intrauterine infection(20.0%,12/60)(χ2 =8.485,P <0.05).Moreover,infants with brain damage had higher levels of IL-1β,IL-6 and TNF-αand lower levels of IL-10 than infants with non-brain damage((6. 33±2.17),(8.20±4.10),(1.46±0.25)and(5.35±2.00)μg·L-1 vs(1.44±1.01),(1.58±2. 33),(1.65±0.30)and(3.57 ± 1.33)μg· L-1 ,respectively;P <0.05).Conclusion Premature brain damage is positively associated with intrauterine infection,and the cytokine network re-sponse may mediate the damage process.