| Objective: 1.To explore the changes of cord blood sTREM-1 and HBP levels in the occurrence and development of FIRS;2.To understand the correlation between cord blood IL-6 and sTREM-1 and HBP and to explore the early diagnosis of sTREM-1 and HBP in FIRS Medium predictive value;3.To investigate whether changes in sTREM-1 and HBP levels can indirectly reflect the occurrence and development of brain injury.Methods: The preterm infants born in the obstetrics department of the Fourth Hospital of Hebei Medical University from August 2018 to November 2019 were selected as the research object,and the preterm infants born during the same period but not in accordance with the FIRS diagnostic criteria were selected as the control group.Exclusion criteria:(1)severe asphyxia or hypoxia during delivery;(2)children with congenital or genetic metabolic diseases,combined with other congenital malformations,and nervous system infections;(3)pregnant mother with anemia,diabetes,hypertension and other non-infectious disease.Umbilical cord blood was collected after birth and placental tissue was collected.The experimental group collected venous blood(72 hours after birth).Serum IL-6,sTREM-1,HBP levels were detected by ELISA,and pathological changes of placenta tissue were observed by HE staining.Means of the two groups were compared using t-test or Mann-Whitney U test;Spearman's linear correlation was used for correlation analysis;chi-square test or Fisher exact probability method was used for counting data.Draw ROC curve to detect the diagnostic value of different indicators.Test level ? = 0.05,P <0.05 was considered statistically significant.Results: 1.There was no significant difference in gender,gestational age and birth weight between the FIRS group and the control group(P> 0.05).2.The levels of sTREM-1,HBP and IL-6 in cord blood of FIRS group at different gestational ages were higher than those in the control group,with significant differences(P <0.05).3.FIRS group: fetal age <32 weeks cord blood sTREM-1,HBP,IL-6 levels are higher than fetal age> 32 weeks,in which HBP,IL-6 have significant differences(P <0.05),and sTREM-1 There was no significant difference(P> 0.05);in the control group: sTREM-1,HBP,and IL-6 levels in cord blood of preterm infants with gestational age <32 weeks and gestational age> 32 weeks were not significantly different(P> 0.05).4.The area under the sTREM-1 and HBP curves of cord blood is 0.844 and 0.878,respectively,which have the value of early prediction of FIRS.5.In the FIRS group,the accumulation and infiltration of inflammatory cells,congestion,and edema were seen in some placental tissues;pathological changes such as necrosis and hyperplasia appeared in some chronic inflammatory tissues.There were no obvious abnormalities in the placenta tissue of the control group.6.Cord blood sTREM-1 and HBP levels were positively correlated with IL-6(P <0.05);cord blood sTREM-1 and HBP levels were positively correlated(P <0.05).7.Cord blood sTREM-1 and HBP levels were positively correlated with venous blood NSE(P <0.05);the incidence of brain injury in preterm infants in the FIRS group was higher than that in the same gestational age control group,which was significantly different(P <0.05);in the FIRS group Umbilical cord blood sTREM-1 and HBP levels in preterm infants with brain injury were higher than those without brain injury.Among them,HBP was significantly different(P <0.05),but sTREM-1 was not significantly different(P <0.05).Conclusions: 1.Umbilical cord blood sTREM-1 and HBP levels of FIRS premature infants were significantly increased,and were positively with IL-6,suggesting that umbilical cord blood sTREM-1 and HBP were involved in the occurrence and development of fetal inflammatory response and aggravated the inflammatory response as an inflammatory medium.2.Umbilical cord blood strem-1 and HBP levels are of great value for early prediction and diagnosis of FIRS.3.The incidence of brain injury in FIRS children was significantly higher than that in the control group,and the umbilical cord blood levels of strem-1 and HBP can indirectly reflect the occurrence of brain injury in premature infants to a certain extent,and are related to the severity of brain injury. |
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