| Objective: 1.To detect the levels of IL-6 and TSP1 in cord blood of children with FIRS,and to explore the relationship between the changes and the occurrence and development of FIRS;2.To understand the correlation between IL-6 and TSP1 levels in cord blood;3.To clarify the changes of TSP1 levels in different gestational ages;4.To clarify the relationship between the changes of TSP1 levels and coagulation abnormalities in children with FIRS.Methods: Premature infants born in the obstetrics department of the Fourth Hospital of Hebei Medical University from May 2017 to October 2018 were selected as the study subjects.Except for those born in the same period who did not meet the FIRS diagnostic criteria,the maternal history of hypertension,diabetes,thyroid dysfunction,heart disease and coagulation dysfunction was excluded.No anticoagulant drugs or blood products were used during childbirth,and prenatal or postnatal or postnatal.Children with asphyxia,hypoxia,severe deformity or genetic metabolic diseases during childbirth were served as control group.After birth,umbilical vein blood serum was collected,placenta,umbilical cord,fetal membranes and other tissues were collected,and venous blood was obtained in the hospital within 24 hours.Serum IL-6 and TSP1 levels were detected by ELISA and placental tissues were stained by HE.Group t test or Mann-Whitney U test were used to compare the mean of the two groups,and Spearman’s linear correlation analysis was used for correlation analysis.Chi-square test was used for counting data.The levels of test methods were all a=0.05,P<0.05 was considered to have statistical significance.Results:1.Inflammatory infiltration was found in placenta tissues of FIRS group,manifested by a large number of inflammatory cell aggregation,tissue congestion,edema,and some chronic inflammatory reactions,including necrosis and proliferation of tissues.2.The levels of IL6 and TSP1 in the FIRS group of different gestational age were higher than those in the control group(P < 0.05);the levels of TSP1 in the cord blood of preterm infants with gestational age < 32 weeks and > 32 weeks had no statistical difference(P > 0.05);the levels of TSP1 in the FIRS group with gestational age > 32 weeks were higher than those in the FIRS group with gestational age < 32 weeks(P < 0.05).3.The abnormal coagulation function of FIRS was higher than that of control group(P < 0.05).The abnormalities caused by single PT extension were not significantly different from those of the control group,while the abnormalities caused by single APTT and single FIB extension were significantly different from those of the control group(P < 0.05).4.There were significant differences in PT,APTT,TT,AT-III,FIB,DD and FDP levels between different gestational age FIRS group and control group(P < 0.05).5.Correlation analysis: The level of TSP1 in cord blood was positively correlated with IL-6;TSP1 in cord blood was positively correlated with PT,APTT,TT,DD and FDP(P < 0.05);TSP1 in cord blood was negatively correlated with AT-III and FIB(P < 0.05).Conclusions:1.Coagulation dysfunction exists in FIRS infants,especially prolonged APTT and hypofibrinogenemia.2.There is no significant change in serum TSP1 level in normal preterm infants of different gestational ages,suggesting that TSP1 is at a relatively constant level within a certain gestational age range.3.The serum TSP1 level in FIRS preterm infants is significantly increased and positively correlated with the level of IL-6,suggesting that TSP1 participates in the initiation of inflammatory factors.Coagulation process can be used as a diagnostic index of FIRS and FIRS combined with coagulation dysfunction. |
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