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Journal of the Korean Society of Neonatology 2004;11(2):170-184.
Published online November 1, 2004.
Significance of Interleukin-6 and Ureaplasma urealyticum Detected by Polymerase Chain Reaction in the Tracheal Aspirates at Birth for the Development of Chronic Lung Disease (CLD) of Prematurity and the Risk Factors for the Different Types of CLD accordin
Dong Woo Son, Beyong Il Kim
1Department of Pediatrics, Gachon Medical School, Inchon, Korea. sondw@hitel.net
2Department of Pediatrics, College of Medicine, Seoul National University, Seoul, Korea.
미숙아 만성폐질환의 발병에서 출생시 기관 흡인액의 Interleukin-6 농도와 Ureaplasma urealyticum 중합효소 연쇄반응 결과의 의미 및 선행질환에 따른 유형별 위험인자 분석
To analyze the significance of interleukin-6 (IL-6) concentration and Ureaplasma urealyticum (UU) from tracheal aspirates (TA) taken immediately after birth in the development of chronic lung disease of prematurity (CLD), and to analyze the risk factors for CLD according to the preceding illnesses. METHODS: A retrospective cohort study was done in 75 inborn preterm infants admitted to a university hospital NICU and intubated at birth for the respiratory care. TA was taken to measure IL-6 by ELISA and to perform UU PCR. The patients were grouped into four, according to the history of respiratory distress syndrome (RDS) and chorioamnionitis (CA). RESULTS: PCR positive rate of UU was 25.3%. Positive PCR was significantly frequent in the patients with CLD or CA. IL-6 in TA was significantly higher with CLD, CA, or positive PCR. Risk factors for CLD were increased IL-6, positive UU PCR, and PDA in all patients. The risk factors for CLD were PDA in RDS(+)CA(-) group [OR 2.11; 95% CI 1.15-3.89]; PDA [OR 12.0; 95% CI 2.50-57.67] and IL-6 (>284.7 pg/mL) [OR 3.75; 95% CI 1.01-13.90] in RDS(+)CA(+) group; and IL-6 (>284.7 pg/mL) [OR 8.25; 95% CI 1.54-44.14] in RDS(-)CA(+) group.
PDA was a risk factor for CLD following RDS and increased IL-6 for CLD following CA. Inflammatory response of fetal lung, measured by IL-6 and UU PCR in TA at birth in preterm infants, was associated with CA and might be a risk factor for the development of CLD.
Key Words: Chronic lung disease of prematurity; Bronchopulmonary dysplasia; Chorioamnionitis; Tracheal aspirates; Interleukin-6; Ureaplasma urealyticum
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