胎粪吸入综合征患儿支气管肺泡灌洗液肿瘤坏死因子-α、白细胞介素-8变化的临床研究

目的 探讨肿瘤坏死因子-α(TNF-α)、白细胞介素-8(IL-8)在胎粪吸入综合征中的作用.方法 对47例胎粪吸入综合征(meeonium aspiration syndrome,MAS)患儿行支气管肺泡灌洗液(bronchoalveolar lavage fluid,BALF)和血清TNF-α、IL-8检测;同时将MAS患儿随机分成固尔苏治疗组和常规治疗组,分别于治疗前、治疗后24 h检测TNF-α、IL-8水平,并进行比较.TNF-α、IL-8采用酶联免疫吸附法(ELISA)检测.结果 MAS患儿血清TNF-α、IL-8水平分别为(25.97±6.72)ng/L和(18.82±4.89)ng/ml,明显高于对照组(11.94±2.83)ng/L和(10.38±2.28)ng/L(P均<0.01);MAS患儿BALF中TNF-α、IL-8水平为(66.46±12.67)ng/L和(31.17±5.67)ng/L,明显高于其血清水平(25.97±6.72)ng/L和(18.82±4.89)ng/L(P均<0.01);固尔苏治疗组24 h后TNF-α、IL-8水平为(36.97±5.88)ng/L和(21.06±3.99)ng/L,比常规治疗组明显降低(44.38±9.10)ng/L和(26.46±5.01)ng/L(P均<0.01).结论 TNF-α、IL-8在MAS发病过程中起重要作用;检测BALF中TNF-α、IL-8水平比血清更加敏感;固尔苏应用能减少MAS患儿TNF-α、IL-8水平,减轻肺损伤.

Variations of TNF-α and IL-8 in bronchoalveolar lavage fluid in neonates with meconium aspiration syndrome

Objective To study the role of TNF-α and IL-8 in neonates with meconium aspiration syndrome(MAS). Methods Forty-seven neonates with MAS were randomly assigned into the treatment group(n=22) and the control group(n=25) and received traditional treatment and Curosurf therapy,respectively.Another 21 full-term newborns were chosen as control.The levels of TNF-α and IL-8 in serum and bronchoalveolar lavage fluid (BALF) were measured after 24 days of treatment. Results Serum levels of TNF-α and IL-8 in neonates with MAS were significantly higher than the control group(25.97±6.72)ng/L vs(11.94±2.83)ng/L;(18.82±4.89)ng/L vs(10.38±2.28)ng/L;P<0.01,respectively].The levels of TNF-α and IL-8 in BALF were(66.46±12.67)ng/L and(31.17±5.67)ng/L]significantly higher than those of the serum(P<0.01,respectively).Compared with the traditional treatment group,levels of TNF-α and IL-8 in BALF at 24 h after Curosurf therapy were lower(44.38±9.10)ng/L vs(36.97±5.88)ng/L and(26.46±5.01)ng/Lvs(21.06±3.99)ng/L,P＜0.01,respectively]Conclusions TNF-α and IL-8 may play an important role in the development of MAS.Curosurf could protect the lungs from injury by reducing the TNF-α and IL-8 levels in neonated with MAS.