IL-6, GM-CSF Detection And Its Clinical Significance In Newborn Infants With Meconium Stained Amniotic Fluid

Objective：Measure the GM-CSF, IL-6level in peripheral blood serum of neonateswith or without amniotic fluid meconium pollution at birth and conduct clinical controlwith blood routine examination and CRP. Combine clinical manifestations of infectedchildren and pathogenesis of the infectious disease to discuss the significance of GM-CSF,IL-6level in serum in diagnosis of neonatal infection disease, as well as their relation withblood routine examination and CRP, so as to provide the theory basis for early clinicaldiagnosis and treatment of neonatal infection.Methods：1.The experimental group84newborn infants in our hospital during the same period were divided into twogroups according to whether there was meconium stained amniotic fluid at birth:(1), The control group:24cases without neonatal amniotic fluid pollution. Theinfection rate was4.2%.(2), The experimental group:60cases with neonatal amniotic fluid pollution,amongwhichⅠ°, Ⅱ°, Ⅲ°amiotic fluid polluted newborns accounted for20casesrespectively.The infection rate was23.3%.2. Sample collection3ml peripheral blood in extremities veins of subject infants within24hours afterbirth. Put1ml in EDTA tube1, which is anticoagulation, free of heat source and endotoxin.Put2ml in EDTA tube2. After centrifugating EDTA tube2for20minutes, separate seruminto3portions and conduct the following detections respectively:(1) Blood routine examination:Automatic blood cell analyzer for the determination of leukocyte, neutrophil, platelet.(2) C reactive protein (CRP), granulocyte-macrophage colony stimulating factor(GM-CSF), interleukin6(IL-6) detection: The detection of CRP is the method of assay kit by particle enhancedimmunoturbidimetric assay; use human GM-CSF test kit double antibody sandwich ELISAmethod assay GM-CSF; human IL-6assay kit double antibody sandwich ELISA methodassay IL-6.Results：1.The infection rate in two groups: in the control group of24none neonatalmeconium pollution cases, the infection rate was4.2%; in the experimental group of60neonatal meconium pollution cases, the infection rate was23.3%. The neonatal infectionrates of two groups significantly differed.(P<0.05).2. White blood cell count:the quantity of white blood cell in the experimental groupwas significantly higher than that in the control group (15.4±4.3*109/L vs11.4±2.7*109/L，P<0.01).3. The percentage of neutrophils (N%): the blood neutrophil percent in neonatalperipheral blood in the experimental group has significantly increased compared to thecontrol group (65.1±12.1%vs53.4±12.7%, P<0.01). The neutrophil percentage differencewas no significant among groups with different degree of pollution (P＞0.05).4. Platelet count: the quantity of platelet in the experimental group was slightly lowerthan that in the control group, with significant difference (269.8±69.6*109/L vs315.6±68.5*109/L, P<0.01); but the quantity of platelet in amniotic fluid Ⅲ°pollutednewborns was significantly lower than that in the control group (P<0.05). Differenceamong different pollution groups were not statistically significant (P>0.05).5. CRP content: the CRP content in peripheral blood of newborns in experimentalgroup was higher than that in the control group (7.8±4.2mg/L vs5.3±4.7mg/L, P<0.05);but the CRP content in amniotic fluid Ⅲ°polluted newborns was higher than that ofcontrol group (p<0.05); difference among different pollution groups was not statisticallysignificant (P>0.05).6. GM-CSF content: the GM-CSF content in peripheral blood of newborns in theexperimental group was significantly higher than that of control group (653.5±153.5ng/Lvs536.3±120.5ng/L,P<0.01); there were significant differences among pollution groups(p<0.05).7. IL-6content: the IL-6content in peripheral blood of newborns in experimentalgroup was higher than that of the control group (62.3±14.6ng/L vs49.6±12.6ng/L, P<0.01); but the IL-6content in amniotic fluid Ⅲ°polluted newborns was significantlyhigher than that in control group (P<0.05); difference among different pollution was notstatistically significant (P>0.05).Conclusion：1. Meconium stained amniotic fluid and maternal prenatal infection and neonatalinfection are closely related.2. The content of GM-CSF in neonates with meconium stained amniotic fluid hassignificantly increased. GM-CSF content was related with amniotic fluid pollution degree.3. The content of IL-6in neonates with aminotic fluid pollution has increased. Theincreasing content of IL-6in amniotic fluid Ⅲ°polluted neonates has great clinicalsignificance.4. GM-CSF, IL-6content in neonates with amniotic fluid pollution, especially theamniotic fluid Ⅲ°polluted newborns, has greater clinical value for diagnosis of infection,compared with WBC, N%, PLT, and CRP. Neonatal pediatricians should pay attention tothe pollution degree and the detection of GM-CSF, IL-6content in amniotic fluid, giveintervention according to specific circumstances.