胆红素对早产儿细胞免疫功能的影响及蓝光照射前后免疫功能的变化

THE EFFECT OF HYPERBILIRUBINEMIA ON PREMATURE INFANTS" CELL IMMUNE FUNCTIONS AND THE CHANGES OF THE IMMUNE FUNCTION AFTER THE TREATMENT OF BLUE LIGHT

目的探讨不同血清胆红素水平对早产儿细胞免疫功能的影响及蓝光照射前后的变化。方法应用流式细胞仪法测定不同胎龄、不同胆红素水平下CD4^+、CD8^+、白细胞介素(interleukin,IL)-4、干扰素-γ(interferon-γ,IFN-γ)的表达。结果①胎龄≥32周早产儿的CD4^+和CD8^+表达量大于胎龄<32周早产儿,二者差异有统计学意义(P<0.05)。②胎龄<32周早产儿和胎龄≥32周早产儿CD4^+的表达量于胆红素153.9～220.6μmol/L组和胆红素≥220.6μmol/L组均明显低于无黄疸组和胆红素≤153.9μmol/L组(P<0.05)。CD8^+的表达量于胆红素≥220.6μmol/L组低于无黄疸组、胆红素≤153.9μmol/L组和胆红素153.9～220.6μmol/L组(P<0.05)。IL-4的表达量于4组比较无差异(P>0.05)。IFN-γ的表达量于胆红素153.9～220.6μmol/L组和胆红素≥220.6μmol/L组均低于无黄疸组和胆红素≤153.9μmol/L组(P<0.05)。③蓝光照射治疗后CD4^+、CD8^+和CD4^+/CD8^+表达量均增高,差异有统计学意义(P<0.05)。光疗前后IL-4表达量的差异无统计学意义(P>0.05)。IFN-γ表达量光疗后低于光疗前,二者差异有统计学意义(P<0.05)。结论①胎龄是影响早产儿免疫功能的一个因素,胎龄越小免疫功能越低。②黄疸对早产儿细胞免疫功能有显著抑制作用,随胆红素浓度的增加抑制作用越显著。③蓝光照射治疗可改善胆红素对细胞免疫功能的抑制作用。

Objective To study the effects of hyperbilirubin on the cell immune function and the changes after the treatment of blue light. Methods After marked by immunofluorescence, CD4 ＋ , CD8＋ ,interleukin（IL） -4, interferon-γ （IFN- γ）were detemined by flow cytometry on different bilirubin concentration levels. Results ①The expression of CD4 ＋ and CD8 ＋ in group of gestational ages ≥32weeks was higher than that of in the group of gestational ages 〈 32weeks. The difference has obvious statistical significance（ P 〈 0.05 ）. ②The expression of CD4 ＋ in group of which bilirubin was 153.9 - 220.6 μmol/L and the group of bilirubin ≥220.6 μmol/L were lower than the group without jaundice and the group of bilirubin ≤ 153.9μmol/L. The expression of CD8 ＋ in group of bilirubin ≥220.6μmol/L was lower than the group without jaundice, the group of bilirubin ≤153.9μmol/L and the group of which bilirubin was 153.9 -220.6μ mol/L. The difference of the expression of IL -4 among the four groups has no statistical significance. The expression of IFN -γ in the group of bilirubin 153.9 -220.6μmol/L and the group of bilirubin ≥220. 6μmol/L were lower than the group without jaundice and the group of bilirubin of ≤153.9μmol/L. ③After blue light treatment the expression of CD4 ＋ , CD8 ＋ and CD4 ＋/CD8 ＋ were higher than those of before the treatment, the difference has statistical significance （ P 〈 0.05）. After blue light treatment, the difference in IL -4 has no statistical significance（ P 〉0.05）. After blue light treatment the expression of IFN - γ was lower than that of before the treatment, the difference has statistical significance （ P 〈 0. 05 ）. Conclusion ①Gestational age is a factor which effects immune function of the premature infants. The younger the gestational age is, the lower the immune function becomes. ②The immune function of the premature infants is inhibited by jaundice obviously. With the increasing of bilirubin concentration, the inhibitory effect of bilirubin on the cell immune function become more significant. ③The blue light treatment can improve the bilirubin＇s inhibitory effect on cell immune function.