光疗对高未结合胆红素血症新生儿细胞免疫功能的影响

Effect of Phototherapy on Cellular Immune Functions of Newborns with Unconjugated Hyperbilirubinemia

目的探讨光疗对新生儿高未结合胆红素血症免疫功能的影响及其机制。方法将100例高未结合胆红素血症足月新生儿随机分成5组:枯草杆菌二联活菌颗粒(妈咪爱)组(A组)、妈咪爱联合连续光疗组(B组)、妈咪爱联合间断光疗组(C组)、连续光疗组(D组)和间断光疗组(E组),5组均在治疗前0 h和治疗第24、48小时抽血分别测定血IL-2、IL-10及血清胆红素水平,分析5组治疗前后各免疫指标的变化。结果 B组、C组、D组、E组治疗第24、48小时IL-2、IL-10水平与治疗前0 h比较均增多,差异均有统计学意义(Pa<0.05);B组、C组、D组、E组治疗第48小时IL-2、IL-10水平与24 h比较也均有增多,差异均有统计学意义(Pa<0.05)。治疗后第24小时血IL-2、IL-10水平比较:B组比C组偏高,D组比E组偏高,差异均有统计学意义(Pa<0.001);治疗后第48小时IL-2比较:B组比C组偏低,D组比E组偏低,差异均有统计学意义(Pa<0.001);治疗后第48小时IL-10的比较:B组比C组偏高,D组比E组偏高,差异均有统计学意义(Pa<0.001)。结论光疗除可降低新生儿血清未结合胆红素水平外,还可使血IL-2、IL-10水平增加,进而影响新生儿的免疫功能,且显示在对高未结合胆红素血症新生儿细胞免疫功能的调节方面间断光疗优于连续光疗。

Objective To investigate the effect and mechanism of phototherapy on the cellular immune functions of newborns with unconjugated hyperbilirubinemia. Methods One hundred full-term newborns with unconjugated hyperbilirubinemia were randomly divided into 5 groups：Medilac-Vita group（group A）,Medilac-Vita with continuous phototherapy group（group B）,Medilac-Vita with intermittent phototherapy group（group C）,continuous phototherapy group（group D）,and intermittent phototherapy group（group E）.Blood samples of the patients in 5 groups were respectively measured of levels of IL-2,IL-10 and serum bilirubin at 0 hour before treatment,24 hours and 48 hours after the treatment to analyze the immune parameters with statistical methodology. Results IL-2 and IL-10 in group B,group C,group D,group E at 24 hours and 48 hours after treatment were all increased compared with 0 hour before treatment in the same group,and the diffe-rences were all statistically significant（Pa0.05）;IL-2 and IL-10 in group B,group C,group D,group E at 48 hours after treatment were all increased compared with 24 hours after treatment in the same group,and the differences were all statistically significant（Pa0.05）;IL-2 and IL-10 were compared between every two groups at 24 hours after the treatment,which in group B was higher than group C,group D was higher than group E,and the diffe-rences were all significant（Pa0.001）;IL-2 in 4 groups were respectively compared at 48 hours after treatment：group B was lower than group C,group D was lower than group E,and the differences were all significant（Pa0.001）;IL-10 in 4 groups were respectively compared at 48 hours after the treatment：group B was higher than group C,group D was higher than group E,and the differences were all very significant（Pa0.001）. Conclusions Phototherapy can stimulate IL-2 and IL-10 to affect the immune function of newborns in addition to reduce the neonatal serum bilirubin levels.It is indicated that intermittent phototherapy is better than continuous phototherapy in improving the cellular immune function of newborns in unconjugated hyperbilirubinemia.