Abstract: Objective To observe the relationship of intrauterine infection interleukin-6 (IL-6),and white matter damage (WMD) in preterm infants. Methods 168 preterm children were enrolled in this study from Jan.2010 to May 2012,and divided into WMD group and control group.Intrauterine infection was determined by membranes,placental pathologic examination,WMD was determined by brain ultrasound,and cord serum IL-6 levels were detected by enzyme-linked immunosorbent. Results The incidence of intrauterine infection was 32.1% ( 54/168 ).29 cases were diagnosed WMD,and the incidence of WMD with intrauterine infection premature infants was higher than that of without intrauterine infection preterm infants[35.2%(19/54) vs.8.8%(10/114),χ²=17.899,P<0.001].Compared with control group,gestational age,sex,birth weight and Apgar score in WMD group showed no statistical differences (P>0.05).The umbilical cord blood level of IL-6 in WMD group was significantly higher than that in control group (P<0.001);and its level in preterm infants with intrauterine infection was significantly higher than that in preterm infants without intrauterine infection(P<0.001). Conclusion Intrauterine infection significantly increased the risk of WMD in preterm infants,and cytokines may mediate the process of brain injury in preterm infants with intrauterine infection.

Key words: intrauterine infection, brain injury, premature infant, interleukin-6

摘要： 目的 早产儿脑白质损伤与宫内感染及白细胞介素-6相关性研究,为临床诊治提供参考依据。 方法 2010年1月-2012年5月出生的168例早产儿纳入研究,分为WMD组和对照组。通过胎膜、胎盘病理检查判断宫内感染,颅脑超声检查判断WMD,酶联免疫吸附法检测脐带血IL-6水平。 结果 168例中宫内感染患病率为32.1%(54/168);脑白质损伤29例,宫内感染患者WMD检出率35.2%(19/54),高于无宫内感染者的8.8%(10/114)(χ²=17.899,P<0.001)。与对照组比较,WMD组胎龄、性别、出生体重及Apgar评分均差异无统计学意义(P>0.05)。脐带血IL-6水平比较,WMD组高于对照组(P<0.001);宫内感染者高于无宫内感染者(P<0.001)。 结论 宫内感染显著增加早产儿脑白质损伤的风险,细胞因子可能介导了宫内感染早产儿脑损伤的过程。

关键词: 宫内感染, 脑损伤, 早产儿, 白细胞介素-6