The Detection Of TNF Alpha And VEGF In Serum Of Children Infected With Bronchiolitis And Its Clinical Significance

Objective:Bronchiolitis is one of common low respiratory infectious diseases in infants of 1-6 months old. Often in winter and spring, it is mainly caused by the RSV(respiratory syncytial virus). Different from other common infective inflammation, its clinical manifestations would deteriorate to be patients’ breathlessness, flaring of alaenasi and chest depression after 2 or 3-day coughing. Even more worse, there would be bluish skin, short of breath and cardiac failure, threatening patient’s lives. So, the early treatment of bronchiolitis with cardiac failure is very important in children. As inflammatory mediators, TNF(tumor necrosis factor-α)and VEGF(vascularendothelial growth factor) are involved in the process of bronchiolitis’ development. Produced by mononuclear macrophage system, TNF is a tumor-killing cytokine, regulating inflammation and immunologic response. TNF alpha is created and released by respiratory epithelial cells, vascular endothelial cells, eosinophile granulocyte, T and B lymphocytes and NK cells. The function of TNF alpha is positively related to the density in tissue. The low-level TNF alpha plays a positive role in inflammation response and tissue repair, and the high-level may cause tissue damage. VEGF may effectively promote cell proliferation, improve the function of endothelial cells, induce production of blood vessel and strengthen vasopermeability. As an extremely sensitive and specific index in early myocardial ischemia, VEGF’s level would greatly rise when the body is in a state of ischemia and hypoxia, which could promote the establishment of myocardial collateral circulation and increase myocardial blood supply. The paper mainly discusses the change of TNF alpha and VEGF before and after the treatment of bronchiolitis with cardiac failure and its clinical significance.Methods: Experiment objects: With the age of ≥28 days and ≤24 months, 68 children diagnosed with bronchiolitis, in PLA 251 Hospital pediatric outpatient and inpatient wards, were randomly selected in January 2014 to January 2015, among which 34 cases(Group A), were only infected with bronchiolitis, including 18 males and 16 females, mean age 9.02±3.54 months, weighing 8.27±1.78kg; 34 cases(Group B), with bronchiolitis and cardiac failure, 20 males and females 14 cases, average age of 7.89±4.02 months, weighing7.89±1.21 kg. Another healthy 30 cases were randomly selected from the same period with the same age as normal control group(Group C), 16 males and 14 females, mean age 8.83 + /- 8.83 months, and weighing 8.43 +/- 2.15 kg. Those, who have had abnormal respiratory system, congenital heart disease, bronchopulmonary dysplasia, combined toxic encephalopathy and convulsion, were deleted. Control group did not suffer from infectious diseases within 2 months, without a history of recurrent respiratory tract infections. And there was also no history of allergies, congenital heart disease, parasitic disease, tumor and autoimmune diseases, without using hormone and immune inhibitors. Experiment methods: Group A and Group B were given anti-infection, eliminating phlegm, cough, asthma, atomization inhalation and other corresponding symptomatic treatment. But Group B was given inspiration of oxygen, cardiac and myocardial protection treatment. 3ml of blood was collected from each of Group A and B on day 1 and after five days of hospitalization. And 3ml of blood was also done from each of Group C. Then the supernatant was extracted centrifuged by using 3000r/min for 10 min and by and stored at-20 ℃. The level of TNF-α and VEGF was determined by Double antibody sandwich enzyme-linked immunosorbent(ELISA) method. All data were collected, sorted out and analyzed with Spss17.0. The variance and homogeneity test were applied to the data, shown by mean ± standard deviation. The chi-square test was used to inter-group differences. Taking α=0.05 was statistically significant, and P <0.05 displayed the difference being statistically significant.Results: 1 The body weight, age, sex ratio between the three groups were of no statistical difference, as P > 0.05. 2 Serum TNF-alpha compare: 2.1 Before treatment: The level of TNF-alpha in Group B serum before treatment significantly higher than that of Group A; that in Group A serum is obviously higher than that of Group C. It is of statistically significant difference(P < 0.05). 2.2 After treatment: The level of TNF-alpha in Group B serum after treatment significantly higher than that of Group A, so the difference is statistically significant(P < 0.05). 2.3 Before and after treatment: The level of TNF alpha before Group A and B treatment is significantly higher than that after treatment, so the difference is statistically significant(P < 0.05). 3 Serum VEGF compare: 3.1 Before treatment: The level of VEGF in Group B serum before treatment significantly higher than that of Group A; that in Group A serum is obviously higher than that of Group C. It is of statistically significant difference(P < 0.05). 3.2 After treatment: The level of VEGF in Group B serum after treatment significantly higher than that of Group A, so the difference is statistically significant(P< 0.05). 3.3 Before and after treatment: The level of VEGF before Group A and B treatment is significantly higher than that after treatment, so the difference is statistically significant(P < 0.05).Conclusion: 1 TNF-alpha is an important factor in the development of bronchiolitis with cardiac failure. It would become the target factor for treating it. 2 VEGF is closely related to the onset of bronchiolitis, whose level of detection is significant for the treatment of bronchiolitis with cardiac failure.