中国妇幼健康研究2026，Vol.37Issue(4)：95-103,9.DOI:10.3969/j.issn.1673-5293.2026.04.014
广谱抗生素使用时间对极低出生体重早产儿炎症因子水平及支气管肺发育不良的影响
Effect of broad-spectrum antibiotics usage duration on inflammatory factor levels and bronchopulmonary dysplasia in very low birth weight premature infants
摘要
Abstract
Objective To explore effect of broad-spectrum antibiotics(abbreviated as ABX)usage duration on inflammatory cytokine levels and bronchopulmonary dysplasia(BPD)in very low birth weight(VLBW)premature infants.Methods 105 VLBW premature infants who admitted to Suqian First People's Hospital from June 2021 to June 2023 were selected as research subjects.According to diagnostic criteria for BPD,they were divided into BPD group(n=42)and non-BPD group(n=63).According to duration of ABX use within 14 days after birth,they were divided into ABX usage duration≤7 d group(n=51)and ABX usage duration>7 d group(n=54).Pearson correlation coefficient method was used to analyze correlations between ABX usage duration and serum inflammatory cytokine levels.Multiple Logistic regression was used to analyze association between ABX usage duration and risk for BPD.Generalized multi-factor dimension reduction model(GMDR)was used to analyze interactions of ABX usage duration and serum inflammatory marker levels at 2 weeks after birth with BPD.Results Compared with the ABX usage duration≤7 d group,the VLBW premature infants in the ABX usage duration>7 d group had higher serum levels of interleukin-6(IL-6),interleukin-8(IL-8),tumor necrosis factor-α(TNF-α),and procalcitonin(PCT)at 2 weeks after birth(t=2.113-9.254,all P<0.05),while they had lower serum level of interleukin-10(IL-10)(t=7.042,P<0.05),there were statistically significant differences.ABX usage duration was positively correlated with IL-6,IL-8,TNF-α and PCT at 2 weeks after birth(r=0.304-0.560,all P<0.05),and negatively correlated with IL-10 at 2 weeks after birth(r=-0.402,P<0.05).Compared with the non-BPD group,the VLBW premature infants in the BPD group had lower birth weight and Apgar score,longer invasive mechanical ventilation(IMV)time,hospital stay and ABX usage duration,and higher proportion of VLBW premature infants undergoing vaginal delivery,IMV,inhaling higher concentration oxygen,using pulmonary surfactant(PS),suffering from intrauterine infection and neonatal asphyxia,and there were statistically significant differences(t/χ2=2.324-49.388,all P<0.05).Compared with the non-BPD group,the VLBW premature infants in the BPD group had higher serum levels of IL-6,IL-8,TNF-α and PCT,and lower serum level of IL-10 at birth,there were statistically significant differences(t=2.637-27.382,all P<0.05).At 2 weeks after birth,the serum levels of IL-8 and PCT of the VLBW premature infants in the BPD group were significantly higher,while their serum level of IL-10 was significantly lower,and the differences were statistically significant(t=3.656-20.420,all P<0.05).Multiple Logistic regression analysis showed an independent correlation between ABX usage duration and BPD risk(OR=1.518,95%CI:1.260-1.626,P<0.05),and the trend test of ABX usage duration from low quartiles to high quartiles showed statistically significant differences(Ptrend<0.05).GMDR analysis showed that after adjusting for confounding factors,the optimal interaction model was the interaction model between ABX usage duration and serum IL-8,IL-10 and PCT at 2 weeks after birth(P<0.05).Conclusion The prolonged use of ABX is significantly correlated with abnormal expression of serum inflammatory markers in VLBW preterm infants and independently associated with the risk of BPD,and clinical control of ABX use time should be implemented to reduce the risk of BPD.关键词
极低出生体重/早产儿/支气管肺发育不良/抗生素/炎症因子Key words
very low birth weight/premature infant/bronchopulmonary dysplasia/antibiotics/inflammatory cytokine分类
医药卫生引用本文复制引用
时丹丹,李秋侠,李欢欢,孙炳霞,陈晶..广谱抗生素使用时间对极低出生体重早产儿炎症因子水平及支气管肺发育不良的影响[J].中国妇幼健康研究,2026,37(4):95-103,9.基金项目
江苏省妇幼健康科研项目(F201643) （F201643）
