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高血压母亲早产新生儿的炎症和氧化应激气道标志物

Inflammatory and oxidative stress airway markers in premature newborns of hypertensive mothers.

作者信息

Madoglio R J, Rugolo L M S S, Kurokawa C S, Sá M P A, Lyra J C, Antunes L C O

机构信息

Curso de Pós-Graduação de Ginecologia e Obstetrícia, Faculdade de Medicina de Botucatu, Universidade Estadual Paulista, Botucatu, SP, Brasil.

Departamento de Pediatria, Faculdade de Medicina de Botucatu, Universidade Estadual Paulista, Botucatu, SP, Brasil.

出版信息

Braz J Med Biol Res. 2016 Aug 1;49(9):e5160. doi: 10.1590/1414-431X20165160.

Abstract

Although oxidative stress and inflammation are important mechanisms in the pathophysiology of preeclampsia and preterm diseases, their contribution to the respiratory prognosis of premature infants of hypertensive mothers is not known. Our objective was to determine the levels of oxidative stress and inflammation markers in the airways of premature infants born to hypertensive and normotensive mothers, in the first 72 h of life, and to investigate whether they are predictors of bronchopulmonary dysplasia (BPD)/death. This was a prospective study with premature infants less than 34 weeks' gestation on respiratory support who were stratified into 2 groups: 32 premature infants of hypertensive mothers and 41 of normotensive women, with a mean gestational age of 29 weeks. Exclusion criteria were as follows: diabetes mellitus, chorioamnionitis, malformation, congenital infection, and death within 24 h after birth. The outcome of interest was BPD/death. Malondialdehyde (MDA), nitric oxide (NO), and interleukin 8 (IL-8) were measured in airway aspirates from the first and third days of life and did not differ between the groups. Univariate and multivariate statistical analyses were performed. The concentrations of MDA, NO, and IL-8 were not predictors of BPD/death. Premature infants who developed BPD/death had higher levels of IL-8 in the first days of life. The gestational age, mechanical ventilation, and a small size for gestational age were risk factors for BPD/death. In conclusion, the biomarkers evaluated were not increased in premature infants of hypertensive mothers and were not predictors of BPD/death.

摘要

尽管氧化应激和炎症是子痫前期和早产疾病病理生理学中的重要机制,但它们对高血压母亲所生早产儿呼吸预后的影响尚不清楚。我们的目的是测定高血压母亲和血压正常母亲所生早产儿出生后72小时内气道中的氧化应激和炎症标志物水平,并研究它们是否是支气管肺发育不良(BPD)/死亡的预测指标。这是一项对小于34周妊娠且需要呼吸支持的早产儿进行的前瞻性研究,这些早产儿被分为两组:32名高血压母亲所生的早产儿和41名血压正常女性所生的早产儿,平均胎龄为29周。排除标准如下:糖尿病、绒毛膜羊膜炎、畸形、先天性感染以及出生后24小时内死亡。感兴趣的结局是BPD/死亡。在出生后第一天和第三天的气道吸出物中检测了丙二醛(MDA)、一氧化氮(NO)和白细胞介素8(IL-8),两组之间没有差异。进行了单因素和多因素统计分析。MDA、NO和IL-8的浓度不是BPD/死亡的预测指标。发生BPD/死亡的早产儿在出生后的头几天IL-8水平较高。胎龄、机械通气和小于胎龄儿是BPD/死亡的危险因素。总之,所评估的生物标志物在高血压母亲所生的早产儿中并未升高,也不是BPD/死亡的预测指标。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d25a/4988474/5575c935f606/1414-431X-bjmbr-1414-431X20165160-gf001.jpg

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