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中华妇幼临床医学杂志(电子版) ›› 2016, Vol. 12 ›› Issue (05) : 597 -602. doi: 10.3877/cma.j.issn.1673-5250.2016.05.019

所属专题： 文献；

论著

孕妇孕期环境性吸烟对其新生儿脐带血白细胞介素-6、-10和C反应蛋白的影响
程贵辉1, 谭小华2,†(), 崔其亮2, 邱其周3, 张慧2, 黄卫亮2   
  1. 1. 510150　广州医科大学附属第三医院儿科中心
    3. 518104　广东，广州医科大学附属深圳沙井医院新生儿科
  • 收稿日期:2016-05-11 修回日期:2016-08-08 出版日期:2016-10-01
  • 通信作者: 谭小华

Influence of environmental tobacco smoke during pregnancy on plasma interleukin-6, -10 and C-reactive protein in neonatal umbilical cord

Guihui Cheng1, Xiaohua Tan2,†(), Qiliang Cui2, Qizhou Qiu3, Hui Zhang2, Weiliang Huang2   

  1. 1. Department of Pediatrics Center, The Third Affiliated of Guangzhou Medical University, Guangzhou 510150 , Guangdong Province, China; Department of Neonatology, Shenzhen Shajing Affiliated Hospital of Guangzhou Medical University, Shenzhen 518104, Guangdong Province, China
    2. Department of Pediatrics Center, The Third Affiliated of Guangzhou Medical University, Guangzhou 510150 , Guangdong Province, China
    3. Department of Neonatology, Shenzhen Shajing Affiliated Hospital of Guangzhou Medical University, Shenzhen 518104, Guangdong Province, China
  • Received:2016-05-11 Revised:2016-08-08 Published:2016-10-01
  • Corresponding author: Xiaohua Tan
  • About author:
    Corresponding author:Tan Xiaohua,Email:
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程贵辉, 谭小华, 崔其亮, 邱其周, 张慧, 黄卫亮. 孕妇孕期环境性吸烟对其新生儿脐带血白细胞介素-6、-10和C反应蛋白的影响[J/OL]. 中华妇幼临床医学杂志(电子版), 2016, 12(05): 597-602.

Guihui Cheng, Xiaohua Tan, Qiliang Cui, Qizhou Qiu, Hui Zhang, Weiliang Huang. Influence of environmental tobacco smoke during pregnancy on plasma interleukin-6, -10 and C-reactive protein in neonatal umbilical cord[J/OL]. Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition), 2016, 12(05): 597-602.

目的

探讨孕妇孕期环境性吸烟(ETS)对新生儿脐带血血浆炎症因子白细胞介素(IL)-6、-10及C反应蛋白(CRP)含量的影响。

方法

选择2013年10月至2015年10月，在广州医科大学附属深圳沙井医院产科住院分娩的352例单胎妊娠产妇及其分娩的352例新生儿为研究对象。通过在产前对孕妇孕期ETS情况进行问卷调查，根据产妇孕期是否有ETS，将产妇及其分娩的新生儿分别纳入ETS组(有ETS)和对照组(无ETS)。调查352例产妇的孕期ETS情况、一般临床资料及分娩新生儿性别。采用酶联免疫吸附测定法，检测新生儿脐带血血浆IL-6、-10及CRP含量。统计学比较：①两组产妇一般临床资料及新生儿性别构成比差异；②两组新生儿之间，以及轻、重型ETS孕妇与对照组孕妇分娩新生儿之间脐带血血浆炎症因子含量两两比较差异；③两组组内与组间早产儿及足月儿脐带血血浆炎症因子含量差异。本研究遵循的程序符合广州医科大学附属深圳沙井医院人体试验委员会制定的伦理学标准，得到该委员会批准，征得受试对象知情同意，并与之签署临床研究知情同意书。

结果

①调查问卷回收率为100.0%。其调查结果显示，ETS产妇及其分娩新生儿均为174例，包括重型ETS产妇74例及轻型ETS产妇100例；无ETS产妇及其分娩新生儿均为178例。两组孕妇文化程度构成比比较，差异有统计学意义(χ2＝8.099，P＝0.017)，ETS组孕妇文化程度较对照组低。而两组孕妇年龄及孕龄，肥胖程度、家庭月人均收入、产妇类型及孕期饮酒情况构成比，以及新生儿性别构成比比较，差异均无统计学意义(P>0.05)。②ETS组新生儿脐带血血浆IL-6和CRP含量较对照组新生儿高，而IL-10含量，则较对照组低，且差异均有统计学意义(P<0.05)；新生儿脐带血血浆IL-6含量随着孕妇ETS加重而逐渐增加，且差异均有统计学意义(P<0.05)。③ETS组早产儿脐带血血浆IL-6及CRP含量较足月儿高，而IL-10含量，则较足月儿低，且差异有统计学意义(P<0.05)；对照组早产儿脐带血血浆IL-6含量较足月儿高，且差异有统计学意义(P<0.05)；ETS组早产儿脐带血血浆IL-6及CRP含量较对照组早产儿高，而IL-10含量，则较对照组早产儿低，且差异有统计学意义(P<0.05)；ETS组足月儿脐带血血浆IL-6含量较对照组足月儿高，且差异有统计学意义(P<0.05)。

结论

孕妇孕期ETS可影响其分娩新生儿体内的炎症反应，增加早产风险。

关键词: 烟草烟污染, 环境性吸烟, 妊娠, 白细胞介素6, 白细胞介素10, 孕妇, 婴儿，新生
Objective

To study the influence of environmental tobacco smoke(ETS) during pregnancy on plasma inflammatory factors interleukin(IL)-6, -10, and C-reactive protein(CRP) contents in neonatal umbilical cord.

Methods

A total of 352 cases of singleton pregnant women and their 352 cases of neonates in Shenzhen Shajing Affiliated Hospital of Guangzhou Medical University from October 2013 to October 2015, were chosen as study objects. According to questionnaire survey results of whether the maternal had ETS or not during pregnancy, the pregnant women and their newborns were divided into ETS group(ETS) and control group(no ETS). Among 352 cases of maternal who were inquired about the ETS situation during pregnancy as well as the general clinical data and the gender of their newborns.Detected plasma IL-6、-10 and CRP contents of neonatal umbilical cord by enzyme-linked immunosorbent assay method. Statistical comparison of: ①The differences between two groups in general clinical data of maternal and gender constituent ratio of newborns; ②The differences between two groups of newborns, and pairwise between newborns of mild or severe of ETS maternal and newborns of no ETS maternal in neonatal umbilical cord blood plasma inflammatory factors contents; ③The differences between preterm infants and term infants in each group or between two groups of neonatal umbilical cord blood plasma inflammatory factors contents.The study protocol was approved by the Ethical Review Board of Investigation in Human Being of Shenzhen Shajing Affiliated Hospital of Guangzhou Medical University.Informed consent was obtained from each participant.

Results

①The questionnaire survey recovery rate was 100.0%.There were 174 cases of ETS maternal or their newborns, including 74 cases of severe ETS maternal and 100 cases of mild ETS maternal, and there were 178 cases of no ETS maternal or their newborns. The constituent ratio of maternal cultural level between two groups has significant difference(χ2=8.099, P=0.017), maternal cultural level of ETS group was lower than that of control group. There were no significant differences between two groups of maternal in maternal age and gestational age, constituent ratio of obesity degree, family monthly income per capita, maternal type and alcohol drinking during pregnancy, and gender constituent ratio of newborns(P>0.05). ②The IL-6 and CRP contents of neonatal umbilical cord blood plasma in ETS group were higher than those of control group, but IL-10 content was lower than that of control group, and the differences were statistically significant(P<0.05); Plasma IL-6 content of neonatal umbilical cord blood gradually increased with maternal ETS aggravated, and the differences were statistically significant (P<0.05); ③Plasma IL-6 and CRP contents of neonatal umbilical cord blood of preterm infants were higher, while IL-10 content was lower than those of term infants in ETS group, and the differences were statistically significant(P<0.05); Plasma IL-6 content of neonatal umbilical cord blood of preterm infants was higher than that of term infants in control group, and the difference was statistically significant(P<0.05); Plasma IL-6 and CRP contents of neonatal umbilical cord blood of preterm infants in ETS group were higher, while IL-10 content was lower than those of preterm infants in control group, and the differences were statistically significant(P<0.05); Plasma IL-6 content of neonatal umbilical cord blood of term infants in ETS group were higher than that of term infants in control group, and the difference was statistically significant(P<0.05).

Conclusions

Maternal has ETS during pregnancy can affect the inflammatory reaction of newborns, and increase the risk of preterm birth.

Key words: Tobacco smoke pollution, Environmental tobacco smoke, Pregnancy, Interleukin-6, Interleukin-10, Pregnant women, Infant, newborn
表1 两组孕妇一般临床资料及新生儿性别构成比比较[例数(%)]
组别 例数 年龄(岁，±s) 孕龄(周，±s) 文化程度构成比 肥胖程度构成比
中学及以下 高中或中专 大专及以上 营养不良(BMI< 18.5 kg/m2) 正常(BMI：18.5～ 23.9 kg/m2) 超重/肥胖(BMI≥ 24.0 kg/m2)
ETS组 174 24.6±3.2 35.2±3.5 66(37.9) 52(29.9) 56(32.2) 32(18.4) 126(72.4) 16(9.2)
对照组 178 24.9±3.9 35.7±3.4 46(25.8) 51(28.7) 81(45.5) 32(18.0) 127(71.3) 19(10.7)
检验值 ? t＝0.788 t＝1.360 ? χ2＝8.099 ? ? χ2＝0.216 ?
P值 ? 0.431 0.175 ? 0.017 ? ? 0.898 ?
组别 例数 家庭月人均收入构成比 产妇类型构成比 孕期饮酒构成比 新生儿性别构成比
<4 000元 ≥4 000元 初产妇 经产妇 无 有 男性 女性
ETS组 174 97(55.7) 77(44.3) 129(74.1) 45(25.9) 167(96.0) 7(4.0) 86(49.4) 88(50.6)
对照组 178 89(50.0) 89(50.0) 137(77.0) 41(23.0) 171(96.1) 7(3.9) 88(49.4) 90(50.6)
检验值 ? χ2＝1.166 χ2＝0.381 χ2＝0.002 χ2＝0.000
P值 ? 0.280 0.537 0.965 0.998
表2 两组新生儿之间，以及轻、重型ETS孕妇与对照组孕妇分娩新生儿之间脐带血血浆炎症因子含量两两比较(±s)
组别 例数 IL-6(ng/L) IL-10(ng/L) CRP(mg/L)
ETS组 174 27.0±10.0 13.5±3.2 4.0±3.1
? 重型 74 30.1±11.4 12.9±3.4 4.3±3.2
? 轻型 100 24.6±8.1 13.9±2.9 3.9±3.0
对照组 178 22.3±7.3 14.8±4.1 3.0±2.2
t值a ? 4.973 3.179 3.508
P值 ? 0.000 0.002 0.001
表3 两组组内与组间早产儿及足月儿脐带血血浆炎症因子含量比较(±s)
新生儿类型 ETS组 对照组
例数 IL-6(ng/L) IL-10(ng/L) CRP(mg/L) 例数 IL-6(ng/L) IL-10(ng/L) CRP(mg/L)
早产儿 96 30.9±9.2 12.6±2.4 4.8±3.3 79 26.3±7.4 14.1±3.9 3.0±2.2
足月儿 78 22.2±8.9 14.7±3.6 3.0±2.4 99 19.1±5.4 15.0±4.0 2.8±1.9
t值 ? 6.299 4.456 3.950 ? 7.282 1.508 0.650
P值 ? 0.000 0.000 0.000 ? 0.000 0.133 0.516
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