Jaarsma Anneke S, Braaksma Margriethe A, Geven Wil B, van Oeveren Wim, Bambang Oetomo Sidarto
Department of Pediatrics, Division of Biocompatibility, University of Groningen, Groningen, The Netherlands.
Biol Neonate. 2004;86(1):1-5. doi: 10.1159/000076366. Epub 2004 Jan 21.
To study the activation of the inflammatory reaction within minutes after birth, we measured parameters of inflammation before and immediately after birth. To assess whether respiratory distress syndrome (RDS) or birth itself initiates activation, we compared preterm ventilated lambs with term nonventilated lambs. Preterm lambs were delivered by cesarean section at 132 days gestational age (term 145 days) and were ventilated by conventional ventilation (n = 9). Before clamping the cord, 5, 10 and 15 min after birth, blood was sampled from umbilical catheters. Term lambs (n = 9) were born spontaneously after 140-145 days gestational age. Immediately after birth, a venous umbilical catheter was inserted. Blood was sampled before the first breath and 5, 10, 15 and 20 min after birth while the lamb was breathing spontaneously. Blood was analyzed for AP50 (complement activation), number of polymorphonuclear leukocytes (PMNs) and beta-glucuronidase (released from activated PMNs). In preterm lambs, we found a decreased number of PMNs and increased levels of beta-glucuronidase already at 5 min after birth. In the term lambs, we found only a short-term mild decrease in PMNs and short-term increase in beta-glucuronidase. We conclude that systemic activation of the inflammatory reaction can be found in ventilated preterm lambs with RDS within 5 min after birth. This very early activation is mild, transient and less pronounced in term-born spontaneously breathing lambs compared with preterm, ventilated lambs with RDS.
为了研究出生后数分钟内炎症反应的激活情况，我们在出生前和出生后即刻测量了炎症参数。为了评估呼吸窘迫综合征（RDS）或出生本身是否引发激活，我们将早产通气羔羊与足月未通气羔羊进行了比较。早产羔羊在妊娠132天（足月为145天）时通过剖宫产分娩，并采用传统通气方式（n = 9）。在钳夹脐带前、出生后5、10和15分钟，从脐静脉导管采集血液样本。足月羔羊（n = 9）在妊娠140 - 145天后自然分娩。出生后即刻插入脐静脉导管。在羔羊自主呼吸时，于第一次呼吸前以及出生后5、10、15和20分钟采集血液样本。对血液进行分析，检测AP50（补体激活）、多形核白细胞（PMN）数量和β - 葡萄糖醛酸酶（从活化的PMN释放）。在早产羔羊中，我们发现出生后5分钟时PMN数量减少，β - 葡萄糖醛酸酶水平升高。在足月羔羊中，我们仅发现PMN有短期轻度减少，β - 葡萄糖醛酸酶有短期升高。我们得出结论，患有RDS的通气早产羔羊在出生后5分钟内可出现全身性炎症反应激活。与患有RDS的早产通气羔羊相比，这种非常早期的激活在足月自然呼吸的羔羊中较为轻微、短暂且不明显。
