Zhang Qiang, Lu Hong-Yan, Wang Jin-Xiu, Mao Xu-Qin, Ma Jiang-Lin, Lu Jun-Ying, Wang Qiu-Xia
Department of Pediatrics, The Affiliated Hospital of Jiangsu University, Zhenjiang, Jiangsu 212001, China.
Zhongguo Dang Dai Er Ke Za Zhi. 2015 Mar;17(3):217-21.
To explore the relationship between histological chorioamnionitis (HCA) and fetal inflammatory response syndrome (FIRS) and brain injury in preterm infants.
One hundred and three singleton infants with premature rupture of membranes (PROM) (gestation ages of less than 34 weeks) were enrolled. All the placentas were submitted for pathological evaluation. Umbilical cord blood interleukin 6 (IL-6), interleukin 8 (IL-8), tumor necrosis factor alpha (TNF-α) and granulocyte-colony stimulating factor (G-CSF) levels were measured with liquid chip. All preterm infants accepted brain imaging examinations. Based on the placental pathological examination and umbilical cord blood level of IL-6, the 103 infants were classified into HCA⁻ FIRS⁻, HCA⁺ FIRS⁻, and HCA⁺ FIRS⁺ groups.
The incidences of HCA, FIRS, and brain injury were 53.4%, 20.4% and 38.8% respectively. The prevalence of brain injury in HCA⁻ FIRS⁻, HCA⁺ FIRS⁻, and HCA⁺ FIRS⁺ cases was 21%, 41%, and 76% respectively (P<0.01). The grade 2 and grade 3 of placental inflammation and the inflammation at stage 2 and stage 3 increased the risk of brain injury. The cord blood levels of IL-8, TNF-α, and G-CSF in the HCA⁺ FIRS⁺ group were significantly higher than in the other two groups, and the levels of the above parameters in the HCA⁺ FIRS⁻ were higher than in the HCA⁻ FIRS⁻ group (P<0.05).
Placental inflammation and FIRS are associated with brain injury in preterm infants. Preterm infants exposed to severe placental inflammation have an increased risk of brain injury. Cord blood IL-8, TNF-α and G-CSF may be involved in the process of brain injury in preterm infants with placental inflammation and FIRS.
探讨组织学绒毛膜羊膜炎（HCA）与胎儿炎症反应综合征（FIRS）及早产儿脑损伤之间的关系。
纳入103例单胎胎膜早破（PROM）（孕周小于34周）的婴儿。所有胎盘均进行病理评估。采用液相芯片检测脐血白细胞介素6（IL-6）、白细胞介素8（IL-8）、肿瘤坏死因子α（TNF-α）和粒细胞集落刺激因子（G-CSF）水平。所有早产儿均接受脑部影像学检查。根据胎盘病理检查及脐血IL-6水平，将103例婴儿分为HCA⁻FIRS⁻、HCA⁺FIRS⁻和HCA⁺FIRS⁺组。
HCA、FIRS和脑损伤的发生率分别为53.4%、20.4%和38.8%。HCA⁻FIRS⁻、HCA⁺FIRS⁻和HCA⁺FIRS⁺病例中脑损伤的患病率分别为21%、41%和76%（P<0.01）。胎盘炎症2级和3级以及2期和3期炎症增加了脑损伤的风险。HCA⁺FIRS⁺组脐血IL-8、TNF-α和G-CSF水平显著高于其他两组，HCA⁺FIRS⁻组上述参数水平高于HCA⁻FIRS⁻组（P<0.05）。
胎盘炎症和FIRS与早产儿脑损伤有关。暴露于严重胎盘炎症的早产儿脑损伤风险增加。脐血IL-8、TNF-α和G-CSF可能参与胎盘炎症和FIRS早产儿脑损伤的过程。
