Cytokine Levels in the Preterm Infant with Neonatal Intestinal Injury
Cytokine Levels in the Preterm Infant with Neonatal Intestinal Injury
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DOI：
10.1055/s-0033-1353437
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发表时间：
2014-06-01
影响因子：
2
通讯作者：
Hamrick, Shannon E.
中科院分区：
文献类型：
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作者：
Bhatia, Amina M.;Stoll, Barbara J.;Hamrick, Shannon E.
目的研究外科坏死性小肠结肠炎(NEC)或自发性肠穿孔(SIP)早产儿手术治疗前细胞因子反应的特点，并探讨其与肠道疾病(NEC与SIP)的关系。研究设计：本研究是一项为期14个月的前瞻性队列研究，研究对象为接受外科手术或引流的早产儿，或接受动脉导管未闭结扎术的新生儿。结果NEC患者术前血清IL-6、IL-6、IL-8、IL-8、IL-6、IL-6、IL-8、IL-6、IL-8、IL-6、IL-6、IL-8、IL-8肿瘤坏死因子-α(NEC161pg/mLp=0.001)、肿瘤坏死因子-α(NEC161pg/mLSIP77pg/mLPDA：71pg/mLp<；0.001)和IL-1β(NEC85pg/mLSIP31pg/mLPDA：24pg/mLp=0.001)。NEC-totalis患儿的IL-8水平最高，与局限性NEC患儿的IL-8水平(28,141 pg/mL比11,429 pg/mL，p=0.03)有显著差异。结论外科NEC是一种比SIR更具促炎性的疾病，其细胞因子谱更接近于非败血症的外科新生儿。
Objectives The purpose of this study is to characterize the cytokine response of preterm newborns with surgical necrotizing enterocolitis (NEC) or spontaneous intestinal perforation (SIP) before surgical treatment and to relate these finding to intestinal disease (NEC vs. SIP).Study Design The study was a 14-month prospective, cohort study of neonates undergoing surgery or drainage for NEC or SIP or surgical ligation of patent ductus arteriosus (PDA). Multiplex cytokine detection technology was used to analyze six inflammatory markers: interleukin-2, interleukin-6 (IL-6), interleukin-8 (IL-8), interleukin-1 beta (IL-1 beta), interferon-gamma, and tumor necrosis factor-alpha (TNF-alpha).Results Patients with NEC had much higher median preoperative levels of IL-6 (NEC: 8,381 pg/mL; SIP: 36 pg/mL; PDA: 25 pg/mL, p < 0.001), IL-8 (NEC: 18,438 pg/mL; SIP: 2,473 pg/mL; PDA: 1,110 pg/mL, p = 0.001), TNF-alpha (NEC: 161 pg/mL; SIP: 77 pg/mL; PDA: 71 pg/mL, p < 0.001), and IL-1 beta (NEC: 85 pg/mL; SIP: 31 pg/mL; PDA: 24 pg/mL, p = 0.001). Patients with NEC totalis (NEC-totalis had the highest levels of IL-8 and were significantly different from infants with limited NEC (28,141 vs. 11,429 pg/mL, p = 0.03).Conclusion Surgical NEC is a profoundly more proinflammatory disease than SIR The cytokine profiles of patients with SIP are closer to those of a nonseptic surgical neonate.