Clinical and Experimental Pediatrics

대한소아청소년과학회 (The Korean Pediatric Society)
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호흡곤란증후군과 기관지폐이형성증 예측 인자로서의 미숙아 제대혈 IL-10, IL-12

Cord blood IL-10, IL-12 in preterm newborns as predictors of respiratory distress syndrome and bronchopulmonary dysplasia

  • 박지윤 (이화여자대학교 의과대학 소아과학교실) ;
  • 김지영 (이화여자대학교 의과대학 소아과학교실) ;
  • 조수진 (이화여자대학교 의과대학 소아과학교실) ;
  • 김영주 (이화여자대학교 의과대학 산부인과학교실) ;
  • 박혜숙 (이화여자대학교 의과대학 예방의학과학교실) ;
  • 하은희 (이화여자대학교 의과대학 예방의학과학교실) ;
  • 박은애 (이화여자대학교 의과대학 소아과학교실)
  • Park, Jee Yoon (Department of Pediatrics, Ewha Womans University, College of Medicine) ;
  • Kim, Ji Young (Department of Pediatrics, Ewha Womans University, College of Medicine) ;
  • Cho, Soo Jin (Department of Pediatrics, Ewha Womans University, College of Medicine) ;
  • Kim, Young Ju (Department of Obstetrics and Gynecology, Ewha Womans University, College of Medicine) ;
  • Park, Hye Sook (Department of Preventive Medicine, Ewha Womans University, College of Medicine) ;
  • Ha, Eun Hee (Department of Preventive Medicine, Ewha Womans University, College of Medicine) ;
  • Park, Eun Ae (Department of Pediatrics, Ewha Womans University, College of Medicine)
  • 투고 : 2006.11.22
  • 심사 : 2007.02.13
  • 발행 : 2007.03.15
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초록

목 적 : 최근 RDS나 BPD이 폐의 미성숙함 뿐만 아니라 손상과 재생, 염증 반응 기전이 관여할 것이라는 주장과 연구들이 대두되고 있다. 이에 본 연구에서는 미숙아의 제대혈에서 IL-10, IL-12를 측정하여 RDS, BPD 발생의 관련성을 살펴보고자 하였다. 방 법 : 2003년 1월부터 2005년 6월까지 임신 중기부터 이대 목동 병원에서 산전 관리를 받고 보호자 동의하에 제대혈 검사가 가능하였던 재태 기간 34주 미만의 미숙아 40명을 대상으로 하였다. 출생 당시 제대혈을 채취하여 혈청 분리 후 영하 $70^{\circ}C$에 보관하였다가 ELISA법을 이용하여 IL-10, IL-12를 측정하였고, 각 주수 기간에 따라 RDS가 있는 군(RDS군)과 RDS가 없는 군(non-RDS군)으로, 그리고 RDS군내에서 BPD가 있는 군(BPD군)과 BPD가 없는 군(non-BPD군)으로 나누어 IL-10, IL-12 및 임상자료들을 비교하고 분석하였다. 이들의 임상적인 자료는 의무기록을 통하여 후향적인 방법으로 얻었다. 결 과 : IL-10은 재태 연령(r=-0.391, P=0.005)이나 출생체중(r=-0.442, P=0.001)과 역의 상관관계가 있었고, IL-12는 재태 연령이나 출생체중과는 상관관계가 없었다. 30-34주 사이의 미숙아를 대상으로 보았을 때 RDS군에서 non-RDS군에 비해 의미 있게 높은 IL-10수치를 나타냈다(1.0 vs 0.1 pg/mL; P=0.001). 하지만 IL-12는 두 군 간의 유의한 차이가 없었다. BPD군과 non-BPD군을 비교하면 IL-10, IL-12 모두 통계적으로 유의한 차이가 없었다. 결 론 : 제대혈 IL-10 농도는 태아의 성숙도를 예측하는 지표로 사용될 수 있을 것으로 생각되고, 높은 IL-10의 수치로 RDS로의 이환을 예측하는 지표로 사용할 수 있을 것으로 생각된다. 그러나 제대혈 IL-10이 BPD로의 이환을 예측하기는 어려울 것으로 보이며, 이에 대한 연구가 더 필요할 것으로 보인다.

Purpose : Inflammation plays a major role in the pathogenesis of RDS and BPD in the immature lung. We investigated the possible role of IL-10 and IL-12 in the cord blood of preterm newborns with RDS or BPD. Methods : Forty preterm newborns whose mothers received antenatal care at Ewha Womans University Mokdong Hospital between January 2003 to June 2005, and agreed to testing their cord blood samples were enrolled. The gestational ages were below 34 weeks. Cord blood level of IL-10 and IL-12 were determined by ELISA. We separated the patients into 2 groups (RDS group and non-RDS group, BPD group and non-BPD group) and compared the cytokine levels and clinical records of the groups. Results : Cord blood IL-10 level showed a significant inverse correlation with gestational age and birth weight (P=0.001, P=0.005). Preterm infants with RDS showed higher IL-10 level (1.0 vs 0.1 pg/mL; P=0.001) in the cord blood than those without RDS. The differences remained statistically significant after correction for the effect of gestational age between both preterm groups. Despite similar cord blood IL-10 levels, preterm infants with BPD showed no significant difference with those without BPD. Conclusion : Cord blood IL-10 levels are increased in preterm infants which may be due to the immuno-suppression occurring during pregnancy and to fetal immaturity because these levels are inversely correlated with the gestational age. So, Cord blood IL-10 level can be used as the predictor of RDS.

키워드

과제정보

연구 과제 주관 기관 : 서울시정 개발연구원

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