Division of Neonatology, Department of Pediatrics, University of Calgary, Alberta Children Hospital, Foothills Medical Centre, Alberta Health Services, Calgary, AB, Canada.
Acta Paediatr. 2010 Mar;99(3):338-43. doi: 10.1111/j.1651-2227.2009.01600.x. Epub 2009 Nov 18.
To investigate if circulating cytokines are related to growth and neurodevelopmental outcome following necrotizing enterocolitis (NEC).
Pro-inflammatory cytokine levels were measured prospectively in 40 neonates and compared with neurodevelopmental outcome. Cytokine levels were measured at the onset of feeding intolerance (Group II, n = 17) or NEC (Group III, n = 10) and at weeks 2-3 in control infants (Group I, n = 13). Neurodevelopmental outcome was assessed at the age of 24-28 months. Data were analysed using descriptive statistics, non-parametric tests and Student t-test.
Median birth weights (range) in groups I, II and III were 1120 (525-1564) g, 1068 (650-1937) g and 1145 (670-2833) g, and median gestational ages (range) were 28 (24-35) weeks 28 (24-35) weeks and 28 (25-37) weeks respectively. NEC occurred in 10 infants. Serum IL-6 (interleukin-6) was elevated in group III, (p = 0.03). Significant developmental delay was found in 12% of the infants in Group II and 20% of the infants in Group III, but no infant in group I. Five infants in group III with NEC (50%), had head ultrasound abnormalities. At 1 year of age, growth, weight and head circumference were significantly different in Group III, however, at two years of age, only height was significantly different, p < 0.02. Although there was wide variation, neonatal cytokine levels tended to be greater in the infants later found to have abnormal cognitive and psychomotor outcomes.
This study suggests that increased serum levels of pro-inflammatory cytokines may play a role in the poor growth and neurodevelopment associated with this high-risk population.
研究坏死性小肠结肠炎（NEC）后循环细胞因子与生长和神经发育结局的关系。
前瞻性测量 40 例新生儿的促炎细胞因子水平，并与神经发育结局进行比较。细胞因子水平在喂养不耐受（II 组，n = 17）或 NEC（III 组，n = 10）发作时以及对照组婴儿（I 组，n = 13）的第 2-3 周进行测量。在 24-28 个月时评估神经发育结局。使用描述性统计、非参数检验和学生 t 检验进行数据分析。
I、II 和 III 组的中位出生体重（范围）分别为 1120（525-1564）g、1068（650-1937）g 和 1145（670-2833）g，中位胎龄（范围）分别为 28（24-35）周、28（24-35）周和 28（25-37）周。10 例婴儿发生 NEC。III 组血清白细胞介素 6（IL-6）升高，p = 0.03。II 组 12%的婴儿和 III 组 20%的婴儿出现明显发育迟缓，但 I 组无婴儿出现。III 组中有 5 例 NEC 婴儿（50%）头部超声异常。在 1 岁时，III 组的生长、体重和头围有显著差异，但在 2 岁时，只有身高有显著差异，p < 0.02。尽管存在很大差异，但新生儿细胞因子水平在后来发现认知和精神运动结果异常的婴儿中往往更高。
本研究表明，促炎细胞因子血清水平升高可能与高危人群的生长不良和神经发育不良有关。
