生长受限早产儿的围生期全身炎症反应。
Perinatal systemic inflammatory responses of growth-restricted preterm newborns.
机构信息
Department of Obstetrics and Gynecology, Brigham & Women's Hospital, Harvard Medical School, Boston, MA 02115, USA.
出版信息
Acta Paediatr. 2013 Oct;102(10):e439-42. doi: 10.1111/apa.12339. Epub 2013 Aug 5.
Abstract
AIM
To compare the early post-natal pattern of systemic inflammation in growth-restricted infants born before the 28th week of gestation to that of appropriately grown peers.
METHODS
We measured the concentrations of 25 inflammation-related proteins in blood spots collected from 939 newborns during the first 2 post-natal weeks. We calculated the odds ratios (99% confidence intervals) that concentrations would be in the highest quartile.
RESULTS
Severely growth-restricted infants (birth weight Z-score <-2) were not at increased risk of systemic inflammation shortly after birth. On post-natal day 14, however, they were significantly more likely than their peers to have a CRP, IL-1β, IL-6, TNF-α, IL-8, MCP-4, ICAM-1, ICAM-3, E-SEL, MMP-9, VEGF-R2 and/or IGFBP-1 concentration in the highest quartile. These increased risks could not be attributed to delivery indication, bacteremia or duration of ventilation.
CONCLUSION
Growth-restricted preterm newborns appear to be at increased risk of elevated concentrations of inflammation-associated proteins by post-natal day 14.
摘要
目的
比较胎龄<28 周生长受限儿与适于胎龄儿出生后早期系统性炎症的差异。
方法
我们检测了 939 例新生儿在出生后前 2 周的血斑中 25 种炎症相关蛋白的浓度。我们计算了浓度处于最高四分位数的比值比（99%置信区间）。
结果
严重生长受限儿（出生体重 Z 评分<-2）出生后短期内并未处于系统性炎症风险增加的状态。然而，在生后第 14 天，与对照组相比，其 C 反应蛋白（CRP）、白介素-1β（IL-1β）、白介素-6（IL-6）、肿瘤坏死因子-α（TNF-α）、白介素-8（IL-8）、单核细胞趋化蛋白-4（MCP-4）、细胞间黏附分子-1（ICAM-1）、细胞间黏附分子-3（ICAM-3）、E-选择素（E-SEL）、基质金属蛋白酶-9（MMP-9）、血管内皮生长因子受体 2（VEGF-R2）和/或胰岛素样生长因子结合蛋白 1（IGFBP-1）浓度处于最高四分位数的风险显著更高。这些增加的风险不能归因于分娩指征、菌血症或通气时间。
结论
生长受限的早产儿在生后第 14 天似乎更易出现炎症相关蛋白浓度升高。
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