脐血CRP、PCT、IL-6与宫内感染早产儿脑损伤的相关性研究

Correlation analysis between cord blood CRP, PCT and IL-6 and brain injury in premature infants with intrauterine infection

摘要

目的 探讨脐血C反应蛋白(CRP)、降钙素原(PCT)和白介素(IL)-6与宫内感染早产儿脑损伤的相关性。方法 选取2020年2月至2023年2月于运城市中心医院出生的522例早产儿为研究对象,检测早产儿脐血CRP、PCT、IL-6水平,根据宫内感染情况(胎盘病理组织检测,确定5个以上中性粒细胞浸润且分布呈弥散性聚集即为感染)将早产儿分为感染组(n=47)与非感染组(n=475),并采用颅脑超声及头颅核磁共振(cMRI)检测早产儿脑损伤情况;再将感染组中颅脑超声或cMRI结果显示脑损伤的早产儿纳入脑损伤组(n=23),颅脑超声及cMRI结果显示正常的早产儿纳入无脑损伤组(n=24)。采用多因素Logistic回归分析脐血CRP、PCT、IL-6与宫内感染早产儿脑损伤的关系。结果 感染组早产儿脐血CRP、PCT和IL-6水平均明显高于非感染组,两组比较差异均有统计学意义(t值分别为31.139、55.033、16.719,P<0.05);感染组早产儿脑损伤发生率(48.94%,23/47)明显高于非感染组(15.79%,75/475),两组比较差异有统计学意义(χ²=30.814,P<0.05)。脑损伤组早产儿脐血CRP、PCT、IL-6水平均明显高于无脑损伤组,两组比较差异均有统计学意义(t值分别为4.117、2.626、2.860,P<0.05)。Spearman相关性分析显示,宫内感染早产儿脑损伤与脐血CRP、PCT和IL-6水平均呈正相关(r值分别为0.300、0.295、0.308,P<0.05)。多因素Logistic回归分析显示,脐血CRP(OR=2.815,95%CI:1.521~5.209)、PCT(OR=2.680,95%CI:1.022~7.031)、IL-6(OR=2.305,95%CI:1.082~4.911)均为宫内感染早产儿脑损伤的影响因素(P<0.05)。结论 宫内感染早产儿脑损伤与脐血CRP、PCT、IL-6水平均呈正相关,临床上可通过监测其水平预防宫内感染早产儿脑损伤。

Abstract

Objective To investigate the correlation between cord blood C-reactive protein (CRP), procalcitonin (PCT), interleukin (IL)-6 levels and brain injury in premature infants with intrauterine infection. Methods 522 premature infants born from February 2020 to February 2023 at Yuncheng Central Hospital were selected as the research subjects. Cord blood CRP, PCT and IL-6 levels were measured. According to the presence of intrauterine infection (determined by placental histopathological examination, with the presence of more than 5 neutrophil infiltrations and diffuse aggregation indicating infection), the premature infants were divided into the infection group (n=47) and the non-infection group (n=475). Furthermore, cranial ultrasound and cranial magnetic resonance imaging (cMRI) were used to assess brain injury in premature infants. In the infection group, premature infants with brain injury confirmed by cranial ultrasound or cMRI were included in the brain injury group (23 cases), while those with normal findings on cranial ultrasound and cMRI were included in the non-brain injury group (24 cases). Multivariable logistic regression analysis was conducted to explore the relationship between cord blood CRP, PCT, IL-6, and brain injury in premature infants with intrauterine infection. Results Cord blood CRP, PCT and IL-6 levels in the infection group of premature infants were significantly higher than those in the non-infection group, with statistically significant differences observed between the two groups (t=31.139, 55.033 and 16.719, respectively, P<0.05). The incidence of brain injury in the infection group of premature infants (48.94%, 23/47) was significantly higher than that in the non-infection group (15.79%, 75/475), with a statistically significant difference between the two groups (χ²=30.814, P<0.05). Spearman correlation analysis results showed that brain injury in premature infants with intrauterine infection was positively correlated with cord blood CRP, PCT and IL-6 levels (r=0.300, 0.295 and 0.308, respectively, P<0.05). Multivariable logistic regression analysis revealed that cord blood CRP (OR=2.815, 95%CI: 1.521-5.209), PCT (OR=2.680, 95%CI: 1.022-7.031), and IL-6 (OR=2.305, 95%CI: 1.082-4.911) were all factors influencing brain injury in premature infants with intrauterine infection (P<0.05). Conclusion Brain injury in premature infants with intrauterine infection is positively correlated with cord blood CRP, PCT and IL-6 levels. Clinical monitoring of the three indicators can help to prevent brain injury in premature infants with intrauterine infection.

关键词

早产儿 / 宫内感染 / 脑损伤 / C反应蛋白 / 降钙素原 / 白介素-6

Key words

premature infant / intrauterine infection / brain injury / C-reactive protein / procalcitonin / interleukin-6

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