新生儿缺氧缺血性脑病外周血T细胞亚群和膜白介素-2受体表达及临床意义

The expression of T subsets and mIL-2R in the peripheral blood of newborns with HIE

目的观察新生儿缺氧缺血性脑病(HIE)患儿外周血T细胞亚群和膜白介素-2受体(mIL-2R)表达,探讨其临床意义。方法安徽省淮南市妇幼保健院新生儿科2002年5月至2003年10月收治HIE患儿32例。以Ficoll-Hypaque常规分离外周血单个核细胞(PBMC),用生物素-链霉亲和素(BSA)系统检测新生儿HIE及足月正常新生儿生后第1、3、7日CD3+、CD4+、CD8+、CD4+/CD8+阳性率,及PHA诱导前后mIL-2R表达水平。结果新生儿HIE患儿生后第1日CD3+、CD4+、CD8+阳性率及CD4+/CD8+、静息期和诱导期mIL-2R表达水平与正常对照组相比,差异有显著性(P<0.01或P<0.05);生后第3日与正常对照组相比,差异有显著性(P<0.05);生后第7日CD3+、CD4+、CD8+与正常对照组相比,差异有显著性(P<0.05),CD4+/CD8+与正常对照组相比,差异无显著性(P>0.05)。在不同程度HIE患儿中,以重度HIE患儿细胞免疫功能异常最明显。结论新生儿免疫细胞幼稚、未分化成熟、表达水平偏低,HIE病理过程有细胞免疫的改变及参与,HIE患儿存在一定程度的细胞免疫功能紊乱。

Objective To observe the expression level of T subsets and membrane interleukin-2 receptor （mIL-2R） in the peripheral blood of newborns with hypoxic ischemic encephalopathy （ HIE） and its clinical manifestation. Methods The peripheral blood mononuclear cells （ PBMC ） of newborns with HIE and normal controls were isolated by routine Ficoll-Hypaque, and its level of CD3^＋ , CD4^＋ , CD8^＋ , CD4^＋/CD8^＋ and mIL-2R induced and not induced by PHA were detected by biotin-streptavidin （ BSA） on spot of the first,third and seventh day. Results After born on spot of the first day,the positive rates of CD3^＋ , CD4^＋ , CD8^＋ CD4^＋/CD8^＋ and mIL-2R induced and not induced were significantly higher in HIE groups than those in normal controls （ P 〈 0. 01 - P 〈 0. 05）. After newborns being born three days,there were significant differences in HIE groups compared with those in normal controls （ P 〈 0. 05）. After newborns being born seven days,the positive rates of CD3^＋ , CD4^＋ , CDs were significantly different in HIE groups from those in normal controls （ P 〈 0. 05）. The levels of CD4^＋/CD8^＋ and mIL-2R induced and not induced by PHA were not significantly different in HIE groups and normal controls （ P 〉 0. 05 ）. The most infantile cellular immune function was existent in newborns with HIE （ severe ）. Conclusion The main character of peripheral blood mononuclear cells of newborns is all infantile and undifferentiated,whose surface sign is infantile,and a few cellular immune can take part in course of HIE. Certain cellular immune function disorder can be in newborns with HIE.