缺氧缺血性脑病新生儿自然杀伤细胞与T细胞亚群的变化及其相关因素

Changes of Natural Killer Cells and T Lymphocyte Subpopulations in Neonates with Hypoxic-Ischemic Encephalopathy and Its Correlation Factors

目的了解缺氧缺血性脑病(HIE)新生儿自然杀伤(NK)细胞及T细胞亚群的变化,观察其与各种因素的相关性。方法应用流式细胞仪测定50例HIE和20例正常新生儿血NK细胞、CD3+、CD4+、CD8+细胞及CD4+/CD8+比值。结果HIE患儿NK细胞和T细胞亚群的表达均明显低于正常新生儿(P均<0.05);中、重度HIE患儿NK细胞和CD3+、CD4+细胞及CD4+/CD8+比值明显均低于轻度HIE(P均<0.05),而不同分度HIE的CD8+细胞则无统计学差异(P均>0.05);NK细胞、CD3+、CD4+及CD4+/CD8+与HIE病情分度均呈负相关(P均<0.05)。NK细胞表达与胎龄呈正相关;CD3+细胞与羊水污染呈负相关(P<0.05);CD4+细胞与羊水污染呈负相关,与出生体质量和Apgar评分呈正相关(P<0.05);CD4+/CD8+比值与分娩方式存在线性相关(P<0.05)。结论缺氧缺血可导致HIE患儿NK细胞活性抑制及T淋巴细胞亚群紊乱,某些因素对细胞免疫功能有一定影响。

Objective To investigate the changes and correlative factors of natural killer （NK）cells and T lymphocyte subpopulations levels in neonates with hypoxic- ischemic encephalopathy（HIE）. Methods Peripheral blood samples were collected from 50 neonates with HIE. The percentages of NK cell （CD3^- CD16^＋ CD56^＋ ） and T lymphocyte subpopulations including CD3^＋ , CD4^＋ , CD8^＋ and CD4^＋/CD8^＋ ratio were determined by Flow Cytometr （FCM）. Meanwhile, 20 healthy neonates were served as controls. Results Levels of NK cell, CD3^＋ ,CD4^＋ , CD8^＋ and CD4^＋/CD8^＋ ratio in neonates with HIE were significantly lower than those in eontrol group （all P〈0.05）. Levels of NK cell, CD3^＋ , CD4^＋ and CD4^＋/CD8^＋ ratio were significantly lower in neonates with moderate to severe HIE than those in mild HIE （all P〈 0.05 ）. There was no significant difference of percentage of CD8^＋ among the stages of HIE （all P 〉 0.05 ）. Spearman correlation analysis showed that there were negative correlation between the NK cell, CD3^＋ , CD4^＋ , CD4^ ＋/CD8^＋ ratio and stages of HIE （all P〈 0.05 ）. No relationship was found between CD8^＋ and stages of HIE （all P 〉0.05 ）. Linearregression analysis showed that there was a positive correlation between NK cell and gestationalages （P〈 0.05 ）, and there was a negative correlation between CD3^＋ and amniotic fluid （P〈 0.05 ）. Positive correlations were found between CD4^＋ and birth weight, as well as Apgar score, and a negative correlation was found between CD4^＋ and amniotic fluid （P〈 0.05 ）. CD4^ ＋/CD8^ ＋ ratio was eorrelated with the mode of delivery （P〈0.05）. Conclusions Hypoxic - ischemic can lead to NK cell depressing and T lymphocyte subpopulations disordering. Some factors have effects on immune function of neonates with HIE.