摘要
目的 探讨早产儿支气管肺泡灌洗液（BALF）中β-联蛋白、转化生长因子β1（TGF-β1）、Clara细胞分泌蛋白16（cc16）、Ⅱ型肺泡细胞表面抗原6（KL-6）水平动态变化在机械通气肺损伤乃至支气管肺发育不良（BPD）中的意义.方法 选择机械通气早产儿60例,将30例诊断为BPD的患儿作为试验组,30例非BPD患儿作为对照组,酶联免疫吸附试验（ELISA）法测定机械通气后所有患儿1,24,48,72 h BALF中β-联蛋白、TGF-β1、cc16、KL-6水平.结果 试验组患儿胎龄及出生体质量明显低于对照组,吸氧时间及机械通气时间明显长于对照组,差异均有统计学意义（P＜0.01）.随着机械通气时间的延长,试验组BALF中β-联蛋白、TGF-β1、KL-6水平呈逐渐升高趋势,cc16水平呈逐渐降低趋势,且机械通气48,72 h后与机械通气1h后比较差异有统计学意义[（304.64±64.84）,（358.39±61.81） ng/L比（251.84±59.51） ng/L; （305.6±76.4）,（380.8±88.3） μgL比（200.5±63.8）μg/L; （972.6±232.0）,（1 114.8±253.1） U/L比（822.2±239.9） U/L;（69.92±12.37）,（57.46±12.22）μg/L比（83.24±15.41）μg/L]（P＜ 0.05）.对照组cc16、TGF-β 1机械通气72 h后与机械通气1h后比较差异有统计学意义[（84.08±19.90） μg/L比（106.90±30.58） μg/L,（185.2±75.3） μg/L比（137.5±59.1） μg/L]（P＜0.01）,而KL-6、β-联蛋白各机械通气时段比较差异无统计学意义（P＞0.05）.试验组各机械通气时段TGF-β1、β-联蛋白水平均高于对照组、cc16水平均低于对照组,而KL-6水平机械通气48,72 h后高于对照组,差异均有统计学意义（P＜0.01）.Pearson分析结果显示,机械通气1h后BALF中TGF-β1与胎龄呈负相关（r=-0.274,P＜ 0.05）,cc16与体质量呈正相关（r=0.375,P＜0.01）,β-联蛋白与体质量呈负相关（r=-0.414,P＜0.01）,β-联蛋白与cc16呈负相关（r=-0.248,P＜0.05）,与TGF-β1呈正相关（r=0.290,P＜0.05）.多元逐步回归分�
Objective To investigate the significance of β-catenin,transforming growth factor-β 1 （TGF-β 1）,Clara cell secretion protein 16 （cc16）,Krebs von den Lungen-6 （KL-6） level changes in bronchoalveolar lavage fluid （BALF） of premature for mechanical ventilation lung injury and bronchopulmonary dysplasia （BPD）.Methods Selected 60 mechanical ventilation preterm infants,basing on the BPD diagnosis criterion that the United States national institutes of health research joint BPD team released in 2001,30 BPD children were disposed as experimental group,other 30 non-BPD children as control group.The levels of β-catenin,KL-6,cc16,TGF-β1 in BALF were measured by enzyme-linked immunosorbent assay（ELISA） after mechanical ventilation 1,24,48,72 h.Results The gestational age and body mass in experimental group were significantly lower than those in control group （P〈 0.01）,the time of mechanical ventilation and oxygen inhalation was significantly longer than that in control group （P 〈 0.01）.The levels of β-catenin,TGF-β 1,KL-6 in 48,72 h after mechanical ventilation in experimental group were significantly higher than those of 1 h [（304.64 ± 64.84）,（358.39 ± 61.81） ng/L vs.（251.84 ± 59.51） ng/L; （305.6 ± 76.4）,（380.8 ± 88.3） μ g/L vs.（200.5 ± 63.8） μ g/L; （972.6 ± 232.0）,（1 114.8 ± 253.1） U/L vs.（822.2 ± 239.9） U/L]（P〈 0.05）,the level of cc16 was significantly lower than that of 1 h[（69.92 ± 12.37）,（57.46 ± 12.22） μg/L vs.（83.24 ± 15.41） μg/L]（P〈 0.05）.The differences of levels ofcc16,TGF-β 1were significant between 72 h and 1 h after mechanical ventilation [（84.08 ± 19.90） μ g/L vs.（106.90 ± 30.58） μg/L,（185.2 ±75.3） μg/L vs.（137.5 ±59.1）μg/L] （P 〈0.01）,the difference of KL-6,β-catenin in various mechanical ventilation time was not statistically significant （P 〉 0.05）.The levels of TGF-β,β-catenin in various mechanical ventilation time in experimental group were significan
出处
《中国医师进修杂志》
2014年第15期17-21,共5页
Chinese Journal of Postgraduates of Medicine
基金
海南省卫生厅2012年度海南省普通科研课题（琼卫2012PT-61）
