新生儿呼吸窘迫综合征合并呼吸机相关肺炎患儿气道灌洗液IL-4和IL-13水平监测

Interleukin-4 and interleukin-13 concentrations in bronchoalveolar lavage fluid in neonates with respiratory distress syndrome and concurrent ventilator-associated pneumonia

摘要:

目的：通过监测新生儿呼吸窘迫综合征（RDS）患儿呼吸机相关肺炎（VAP）气道灌洗液中IL-4和IL-13含量，了解发生VAP时免疫调节功能。方法：68名机械通气>48 h的RDS新生儿作为研究对象，其中发生VAP的患儿37名，未发生VAP的31名。用ELISA法测定机械通气后1 h，72 h及96 h支气管肺泡灌洗液中IL-4和IL-13 水平。结果：机械通气后96 h VAP组支气管肺泡灌洗液中IL-4水平显著高于非VAP组（35.34±1.78 ng/L vs 13.69±2.47 ng/L; P<0.05）; IL-13水平亦显著高于非VAP组（33.74±2.74 ng/L vs 13.50±3.81 ng/L; P<0.05）。随着上机时间的延长，VAP组支气管肺泡灌洗液中IL-4及IL-13含量逐渐增加，上机后96 h与1 h比较差异均有显著性（P<0.05）。结论：新生儿RDS患儿在合并VAP时支气管灌洗液中IL-4及IL-13浓度增高，提示IL-4及IL-13参与了体内免疫反应的调节。［中国当代儿科杂志，2009，11（8）：645-648］

Abstract:

OBJECTIVE: To study the concentrations of IL-4 and IL-13 in bronchoalveolar lavage fluid (BALF) in neonates with respiratory distress syndrome (RDS) and concurrent ventilator-associated pneumonia (VAP). METHODS: Sixty-eight neonates with RDS undergoing mechanical ventilation for over 48 hrs were enrolled. IL-4 and IL-13 levels in BALF were measured using ELISA 1, 72 and 96 hrs after mechanical ventilation. The results were compared between the neonates with concurrent VAP (n=37) and without (n=31). RESULTS: The levels of BALF IL-4 96 hrs after ventilation in the VAP group (35.34±1.78 ng/mL) were significantly higher than those in the non-VAP group (13.69±2.47ng/mL, P<0.05). The levels of BALF IL-13 96 hrs after ventilation in the VAP group (33.74±2.74 ng/mL) also increased significantly compared with those in the non-VAP group (13.50±3.81 ng/mL) (P<0.05). There were significant differences in BALF IL-4 and IL-13 levels between 1 hr and 96 hrs in the VAP group (P<0.05).ConclusionsBALF IL-4 and IL-13 levels increase in neonates with RDS and concurrent VAP. IL-4 and IL-13 may involve in the regulation of the inflammatory immue response.［Chin J Contemp Pediatr, 2009, 11 (8):645-648］