尿β2-微球蛋白与支气管肺发育不良：早产儿的相关趋势
Urinary β2-microglobulin and bronchopulmonary dysplasia: Trends in preterm infants.
作者信息
Shima Yoshio, Kumasaka Sakae, Nishimaki Shigeru
机构信息
Department of Neonatal Medicine, Nippon Medical School, Musashikosugi Hospital, Kanagawa, Japan.
Department of Pediatrics, Japanese Red Cross Maternity Hospital, Tokyo, Japan.
出版信息
Pediatr Int. 2017 Nov;59(11):1169-1173. doi: 10.1111/ped.13407.
BACKGROUND
The developmental process of bronchopulmonary dysplasia (BPD) is not identical between very preterm infants born small for gestational age (SGA) and those born appropriate for gestational age (AGA). In this study, we compared the pattern of the inflammatory response in infants of each group, by measuring urinary β2-microglobulin (Uβ2M) as an alternative, concise, and less-invasive biomarker.
METHODS
Uβ2M and clinical details were examined at birth and at 4 weeks of age in 146 very preterm infants.
RESULTS
Of the 57 infants diagnosed with BPD, 18 were SGA, and 39 were AGA. Uβ2M at birth was significantly lower in SGA BPD infants than in AGA BPD infants, but it increased with time. The prevalence of chorioamnionitis (CAM) was significantly lower in SGA BPD infants than in AGA BPD infants, while that of pregnancy-induced hypertension was the opposite.
CONCLUSIONS
Exposure to prenatal factors other than CAM may sensitize fetal lungs to become vulnerable to postnatal inflammation in very preterm SGA infants with BPD.
背景
小于胎龄（SGA）的极早产儿与适于胎龄（AGA）的极早产儿支气管肺发育不良（BPD）的发育过程并不相同。在本研究中，我们通过测量尿β2微球蛋白（Uβ2M）作为一种替代性、简洁且侵入性较小的生物标志物，比较了每组婴儿的炎症反应模式。
方法
对146例极早产儿在出生时和4周龄时检查Uβ2M及临床细节。
结果
在57例诊断为BPD的婴儿中，18例为SGA，39例为AGA。SGA BPD婴儿出生时的Uβ2M显著低于AGA BPD婴儿，但随时间增加。SGA BPD婴儿绒毛膜羊膜炎（CAM）的患病率显著低于AGA BPD婴儿，而妊娠高血压的患病率则相反。
结论
除CAM外，暴露于产前因素可能使极早产SGA BPD婴儿的胎儿肺对产后炎症敏感。
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