2025 年第 3 期 第 20 卷

血清炎症指标与新生儿胎粪吸入综合征相关性分析

Analysis of the correlation between serum inflammatory markers and neonatal meconium aspiration syndrome

作者：刘启星杨杰

英文作者：Liu Qixing Yang Jie

单位：南方医科大学南方医院新生儿科，广州510000

英文单位：Department of Neonatology Southern Hospital of Southern Medical University Guangzhou 510000 China

关键词：胎粪吸入综合征；新生儿；肿瘤坏死因子；白细胞介素

英文关键词：Meconiumaspirationsyndrome;Newborn;Tumornecrosisfactor;Interleukin

• 摘要：

• 目的 探讨血清炎症指标肿瘤坏死因子α（TNF-α）、白细胞介素6（IL-6）与新生儿胎粪吸入综合征（MAS）的相关性。方法 选择2022年3月至2023年4月在南方医科大学南方医院出生并入住新生儿科的MAS足月新生儿58例作为观察组，选择同期羊水清亮且健康正常的足月新生儿60例作为对照组，采用酶联免疫吸附试验法检测TNF-α、IL-6水平。再根据MAS严重程度，将58例MAS患儿分为轻度组（40例）和重度组（18例）。对比各组间的IL-6、TNF-α差异，分析IL-6、TNF-α与MAS的关系。结果 观察组入院第1、5天的IL-6、TNF-α水平均高于对照组（均P＜0.05）。受试者工作特征曲线显示，IL-6诊断MAS的敏感度、特异度、曲线下面积分别为76.90%、76.00%、0.825，TNF-α诊断MAS的敏感度、特异度、曲线下面积分别为84.60%、76.00%、0.869（均P＜0.05）。重度组女性比例高于轻度组，入院第1、5天的IL-6、TNF-α水平高于轻度组（均P＜0.05）。Logistic回归分析结果提示，入院第5天IL-6、TNF-α与重度MAS的发生相关（比值比=1.145，95%置信区间：1.022～1.283，P=0.019；比值比=1.367，95%置信区间：1.067～1.751，P=0.013）。结论 IL-6、TNF-α在MAS特别是重度MAS中呈高表达，可以反映炎症反应及缺氧程度，为MAS诊断及MAS患儿的病情评估提供重要参考依据。

• Objective  To investigate the correlation between serum inflammatory markers tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6) and neonatal meconium aspiration syndrome (MAS). Methods Fifty-eight full-term neonates with MAS who were born in Southern Hospital of Southern Medical University and admitted to the Department of Neonatology from March 2022 to April 2023 were selected as the observation group, and 60 full-term neonates with clear amniotic fluid and normal amniotic fluid during the same period were selected as the control group. The levels of TNF-α and IL-6 were detected by enzyme-linked immunosorbent assay. According to the severity of MAS, the 58 children with MAS were divided into mild group (40 cases) and severe group (18 cases). The levels of TNF-α and IL-6 in each group were compared. The relationship between MAS and the levels of TNF-α and IL-6 was analyzed. Results The levels of IL-6 and TNF-α in the observation group were higher than those in the control group on the 1st and 5th day after admission (all P＜0.05). The receiver operating characteristic curve showed that the sensitivity, specificity and area under the curve of IL-6 in the diagnosis of MAS were 76.90%, 76.00% and 0.825, respectively. The sensitivity, specificity and area under the curve of TNF-α in the diagnosis of MAS were 84.60%, 76.00% and 0.869, respectively (all P＜0.05). The ratio of female in the severe group was higher than that in the mild group, and the levels of IL-6 and TNF-α in the severe group were higher than those in the mild group on the 1st and 5th day after admission (all P＜0.05). The results  of Logistic regression analysis showed that the levels of IL-6 and TNF-α in the 5th day after admission were related to the occurrence of severe MAS (odds ratio=1.145, 95% confidence interval: 1.022-1.283, P=0.019; odds ratio=1.367, 95% confidence interval: 1.067-1.751, P=0.013). Conclusion The expressions of IL-6 and TNF-α in MAS, especially in severe MAS, are high, which can reflect the degree of inflammation and hypoxia, and provide important reference for the diagnosis of MAS and the evaluation of MAS.