新生儿缺氧缺血性脑病红细胞免疫功能的变化及其影响因素

The change and its influential factors of erythrocyte immune function in neonates with hypoxic-ischemic encephalopathy

目的了解新生儿缺氧缺血性脑病(hypoxic-ischemicencephalopathy,HIE)的红细胞免疫功能状态及各种因素对其的影响。方法采用郭峰红细胞酵母花环法对73例HIE检测红细胞C3b受体花环率(RBC-C3bRR)、红细胞免疫复合物花环率(RBC-ICR),并与104例正常新生儿进行对照。结果①HIE患儿的RBC-C3bRR低于正常对照组,其RBC-ICR高于对照组,差异有显著性(P<0.01);②中、重度HIE患儿的RBC-C3bRR低于轻度HIE患儿(P<0.01);不同程度的HIE患儿间RBC-ICR差异无显著性;③HIE伴出血、硬肿症患儿的RBC-ICR增高,而RBC-C3bRR差异无显著性。④HIE患儿的红细胞免疫功能与性别、胎龄、日龄、脐带、羊水、Apgar评分等因素无明显相关性。结论新生儿HIE的红细胞免疫功能低下,而且HIE病情程度越严重,红细胞免疫功能低下越明显。

Objectives To study the state of erythrocyte immune function in neonates with hypoxic- ischemic encephalopathy （HIE）,and analyze the effect of various clinical status. Methods 73 neonates with HIE were enrolled with 104 healthy neonates as the control group. The adherence rate of complement 3b-receptor on the surface of red blood cell （RBC-C3bRR） and the immune complex adherence rate of red blood cell （RBC-ICR） were detected with GUO Feng＇s erythrocyte saccha- romycete rosettet test. Results （1） The level of RBC- C3bRR in neonates with HIE was （13.37 ±1.68） % lower than in control group,and the level of RBC-ICR in neonates with HIE was （5.72 ±1.63） % higher than the control group （P 〈 0.01 ）. （2） The level of RBC-C3bRR was lower in neonates with moderate to severe HIE than the mild, but the level of RBC-ICR was no significant different in all degrees of HIE. （3） The level of RBC-ICR was increased in neonates with HIE complicating hemorrhagic disease and sclerema,but no difference in RBC-C3bRR level. （4） There were no correlation between the state of erythrocyte immune function in neonates with HIE and various factors,such as gender,gestation age,character age,birth weight,presentation labor and Apgar＇s score,as well as umbilical cord or amniotic fluid abnormality,et al. Conclusions Erythrocyte immune function is obviously decreased in neonatal HIE. Furthermore, the more severe HIE, the less vigorous erythrocyte immune function could be discovered.