呼吸机相关性肺炎新生儿血清及支气管肺泡灌洗液中炎症因子和氧化指标的动态变化及其临床意义

发布时间：2018-04-12 21:41

本文选题：呼吸机相关性肺炎 + 肺泡灌洗液　；参考：《东南大学学报(医学版)》2017年04期

【摘要】：目的:探讨呼吸机相关性肺炎(ventilator associatel peneumonia,VAP)新生儿血清和支气管肺泡灌洗液(bronchial pulmonary dysplasia,BALF)中白介素1(interleukin-1,IL-1)、白介素2(interleukin-2,IL-2)、白介素6(interleukin-6,IL-6)、白介素8(interleukin-8,IL-8)和肿瘤坏死因子-α(tumor necrosis factor alpha,TNF-α)等炎症因子以及超氧化歧化酶(superoxide dimutase,SOD)、丙二醛(malondialdehyde,MDA)和髓过氧化物酶(Myeloperoxidase,MPO)等氧化指标动态变化及临床意义。方法:对80例接受机械通气的新生儿进行临床分析,分别在气管插管后24、48、96 h采集外周血和BALF,测定IL-1、IL-2、IL-6、IL-8、TNF-α、SOD、MDA和MPO水平。将新生儿根据是否发生VAP分为VAP组和NVAP组,其中VAP组40例,NVAP组40例。结果:两组气管插管后24 h血清和BALF中炎症因子和氧化指标均无显著性差异(P0.05)。气管插管后48、96 h两组血清和BALF中IL-1、IL-6、IL-8、TNF-α、MDA和MPO水平明显增高(P0.05),IL-2和SOD水平明显降低(P0.05);与NVAP组比,VAP组血清和BALF中IL-1、IL-6、IL-8、TNF-α、MDA和MPO水平明显增高(P0.05),IL-2和SOD水平明显降低(P0.05)。结论:随着机械通气时间的延长,VAP组血清及BALF中IL-1、IL-6、IL-8和TNF-α促炎因子水平升高,IL-2抗炎因子水平降低,促炎和抗炎平衡打破;MDA和MPO水平增高,SOD抗氧能力降低,氧化还原系统平衡打破。临床中在诊断和评估VAP病情时,尤其应关注血清及BALF中IL-8的变化。
[Abstract]:Dynamic changes and clinical significance of oxidative indexes such as superoxide dismutase (SOD), malondialdehyde (malondialdehyde) (MDAs) and myeloperoxidase (MPO).The newborns were divided into VAP group and NVAP group according to the occurrence of VAP. 40 cases in VAP group were divided into two groups: VAP group (n = 40) and NVAP group (n = 40).Results: there was no significant difference in inflammatory factors and oxidation indexes in serum and BALF 24 h after tracheal intubation between the two groups (P 0.05).Conclusion: with the prolongation of mechanical ventilation time, the levels of IL-6, IL-8 and TNF- 伪 pro-inflammatory factor in serum and BALF of VAP group increased, while the level of IL-2 anti-inflammatory factor decreased, the level of MDA and MPO increased and the balance of redox system broke down.In clinical diagnosis and evaluation of VAP, we should pay attention to the changes of IL-8 in serum and BALF.
【作者单位】：桂林医学院第二附属医院新生儿科;桂林医学院附属医院儿科;
【分类号】：R722.1

【相似文献】