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(P>0.05)。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(P<0.05),IL-2和SOD水平明显降低(P<0.05);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(P<0.05),IL-2和SOD水平明显降低(P<0.05)。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。
Objective： To study the serum and bronchoalveolar lavage fluid（ BALF） of interleukin-1（ IL-1）,interleukin-2（ IL-2）,interleukin-6（ IL-6）,interleukin-8（ IL-8） and tumor necrosis factor-α（ TNF-α） and superoxide dismutase（ SOD）,malondialdehyde（ MDA） and myeloperoxidase（ MPO） in neonatal ventilator-associated pneumonia（ VAP）. Methods： 80 patients receiving mechanical ventilation neonate were collected and IL-1,IL-2,IL-6,IL-8,TNF-α,SOD,MDA and MPO in blood and BALF after intubation 24 h,48 h and 96 h were collected. 80 patients were divided into 2 groups： 40 cases in the VAP group and 40 cases in the NVAP group. Results：24 h after intubation,IL-1,IL-2,IL-6,IL-8,TNF-α,SOD,MDA and MPO in serum and BALF of the two groups had no significant differences（ P〈0. 05）. After intubation 48 h and 96 h,IL-1,IL-6,IL-8,TNF-α,MDA and MPO in serum and BALF had increased,IL-2 and SOD had decreased in the two groups（ P〈0. 05）.Compared with the NVAP group,IL-1,IL-6,IL-8,TNF-α,MDA and MPO in serum and BALF had increased,IL-2 and SOD had decreased in the VAP group（ P〈0. 05）. Conclusion： With the prolonging of the mechanical ventilation,the VAP patients＇ IL-1,IL-6,IL-8,TNF-α,MDA and MPO in BALF and srum have increased,IL-2 and SOD have decreased,which measns cytokine and redox play important roles in the development of VAP. IL-8 in serum and BALF should be paid more attention in VAP development.
出处
《东南大学学报（医学版）》
CAS
北大核心
2017年第4期603-608,共6页
Journal of Southeast University(Medical Science Edition)
