胎盘炎症及胎儿炎症反应综合征与早产儿脑损伤的关系研究

发布时间：2018-03-04 01:26

本文选题：胎盘炎症　切入点：胎儿炎症反应综合征　出处：《中国当代儿科杂志》2015年03期 　论文类型：期刊论文

【摘要】：目的探讨胎盘组织学绒毛膜羊膜炎(HCA)及胎儿炎症反应综合征(FIRS)与早产儿脑损伤的关系。方法选取胎龄34周以下并伴有胎膜早破(PROM)的单胎早产儿103例,分为HCA-FIRS-、HCA+FIRS-、HCA+FIRS+等3组,采用液相芯片分析技术检测脐血IL-6、IL-8、肿瘤坏死因子-α(TNF-α)、粒细胞集落刺激因子(G-CSF)水平。结果 HCA发生率、FIRS及脑损伤发生率分别为53.4%、20.4%、38.8%。HCA-FIRS-、HCA+FIRS-、HCA+FIRS+组脑损伤发生率分别为21%、41%和76%(P0.01)。胎盘2级和3级炎症及炎症的2期和3期均是早产儿脑损伤的危险因素(P0.01)。HCA+FIRS+组IL-8、TNF-α及G-CSF水平明显高于另外2组,且HCA+FIRS-高于HCA-FIRS-组(P0.05)。结论胎盘炎症合并FIRS与早产儿脑损伤密切相关,且胎盘炎症程度越重、进展越快,早产儿脑损伤发生风险越高。IL-8、TNF-α及G-CSF可能在胎盘炎症合并FIRS的早产儿脑损伤发生过程中起重要介导作用。
[Abstract]:Objective to investigate the relationship between placental histopathological chorioamnionitis (HCA) and fetal inflammatory response syndrome (FIRS) and brain injury in premature infants. Methods 103 cases of single premature infants under 34 weeks of gestational age with premature rupture of membranes were divided into three groups: HCA-FIRS-HCA and FIRS-HCA FIRS. The levels of IL-8, TNF- 伪 and G-CSF in cord blood were detected by liquid chip analysis. Results the incidence of HCA and brain injury were 53.40.44% and 38.8% respectively. The incidence of brain injury in HCA-FIRS-HCA FIRS-HCA FIRS group was 21 1% and 76% respectively. The levels of IL-8 TNF- 伪 and G-CSF in the FIRS group were significantly higher than those in the other two groups. HCA FIRS- was higher than HCA-FIRS- group (P 0.05). Conclusion placental inflammation combined with FIRS is closely related to brain injury in premature infants, and the more severe the degree of placental inflammation, the faster the progress is. The higher the risk of brain injury in preterm infants, the higher the risk. IL-8 TNF- 伪 and G-CSF may play an important role in the pathogenesis of brain injury in premature infants with placental inflammation and FIRS.
【作者单位】：江苏大学附属医院儿科;常州市妇幼保健院;镇江市妇幼保健院;
【分类号】：R722.6;R714.5

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