新生儿高胆红素血症红细胞免疫功能的变化及其影响因素

Changes of Erythrocyte Immune Function in Neonates with Hyperbilirubinemia and Its Influential Factors

目的研究高胆红素血症新生儿的红细胞免疫功能状态,观察各种因素对红细胞免疫功能的影响。方法采用酵母多糖花环试验法对52例高胆红素血症新生儿测定红细胞C3b补体受体花环(RBC-C3bRR)和红细胞免疫复合物受体花环(RBC-ICR),并与104例正常新生儿进行对比。结果1.高胆红素血症患儿RBC-C3bR低于正常新生儿,而RBC-ICR则高于正常新生儿,差异有显著性(Pa<0.01);2.不同总胆红素水平的新生儿间比较,RBC-C3bRR无统计学差异(Pa>0.05),RBC-ICR有显著性差异(Pa<0.05);3.不同血清未结合胆红素水平的高胆红素血症患儿间进行比较,RBC-ICR有显著性差异(Pa<0.05),RBC-C3bRR无明显差异(Pa>0.05);4.相关分析表明,高胆红素血症患儿的RBC-ICR与总胆红素、未结合胆红素水平间呈显著正相关(Pa<0.05);RBC-C3bRR与光疗时间呈正相关(P<0.05);高胆红素血症患儿的红细胞免疫功能与胎龄、日龄、喂养方式等因素无明显相关性(Pa>0.05)。结论新生儿高胆红素血症的红细胞免疫功能低于正常新生儿,并与血清胆红素水平及光疗时间的影响有关。

Objective To study the state of erythrocyte immune function in neonates with hyperbilirubinemia ,and analyze the influence of various clinical status on erythrocyte immune function. Methods Fifty - two neonates with hyperbilirubinemia were enrolled and 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 erythrocyte saccha - romycete rosettet test. Results 1. The level of RBC -C3bRR in neonates with hyperbilirubinemia was lower than that in control group, and the level of RBC - ICR in neonates with hyperbilirubinemia was higher than that of control group （ Pa 〈 0.01 ）. 2. In different concentrations, there were significant difference in RBC - ICR （ Pa 〈 0.05 ） , and no difference in RBC - C3 bRR （ Pa 〉 0.05 ）. 3. Comparing the neonates with uneonjugated bilirubin of different concentrations, there were significant difference in RBC - ICR （ Pa 〈 0.05 ） and no difference in RBC - C3bRR （ Pa 〉 0.05 ）. 4. There were positive correlation between RBC - ICR and bilirubin, unconjugated hilirubin in the neonates（ P. 〈 0.05 ）, and between RBC - C3bRR and time of the phototherapy（ P 〈 0.05 ）. There were no correlation between the state of erythrocyte immune function in neonates with hyperbilirubinemia and some factors, such as gestational age, daily age and feeding patterns（ P. 〉 0.05 ）. Conclusion Erythrocyte immune function in neonates with hyperbilimbinemia is obviously lower than that of control group and it is influenced by the concentratron of bilirubin and the time of phototherapy.