新生儿败血症单核细胞CD14^+/CD16^+表达水平测定及其临床意义

The expression of CD14^+/CD16^+ by monocytes in neonate septicemia and its clinical significance

目的 :探讨新生儿败血症患儿单核细胞CD14+ CD16 + 表达水平及其临床意义。方法 :用流式细胞术测定血中单核细胞CD14+ CD16 + 表达水平 ,用放射酶联免疫吸附试验测定血中IL 6 ,IL 10和TNF α水平 ,用Bactec 912 0细菌培养系统进行血培养和药物敏感试验。结果 :新生儿败血症组血中单核细胞CD14+ CD16 + 表达水平 ,IL 6 ,TNF α水平显著高于正常新生儿组和非败血症组 (P <0 0 1) ,而IL 10水平则显著低于正常新生儿组和非败血症组 (P <0 0 1) ;非败血症组单核细胞CD14+ CD16 + 表达水平与正常组无显著性差异 (P >0 0 5 ) ;败血症组单核细胞CD14+ CD16 + 表达水平与其IL 6 ,TNF α水平呈显著正相关 (P <0 0 1) ,与IL 10呈负相关 (P <0 0 1) ;败血症组单核细胞CD14+ CD16 + 表达水平随病情好转而逐渐降低 ,病情危重时则持续高表达。结论 :新生儿血中单核细胞CD14+ CD16 + 表达水平仅在败血症时显著增高 ,并随病情而变化 ,因此 ,它可能对败血症具有诊断意义 ,与败血症的预后有一定联系。

Objective:To investigate the expression of CD14 +/CD16 + by monocytes in neonate septicemia and its significance.Methods:The expression of CD14 +/CD16 + by monocytes in 124 neonates was analyzed by Flow cytometry,the levels of IL 6、IL 10 and TNF α in blood was measured by radioimmunoassay and bacteria culture and drug sensitive were tested by Bactec 9120 bacteria culture system.Results:The expression levles of CD14 +/CD16 + by monocytes and the levels of IL 6 and TNF α in the septicemia group were significantly higher than those in the normal group and non septicemia group (P<0.01).However,the levels of IL 10 was significantly lower in the septicemia group(P<0.01).The expression of CD14 +/CD16 + by monocytes showed a positive correlation to the levels of IL 6 and TNF α(P<0.01) and a negative correlation to the level of IL 10(P<0.01);The expression of CD14 +/CD16 + by monocytes changed with the condition of the sick neonates.Conclusion:The expression of CD14 +/CD16 + by monocytes was increased in the neonates with septicemia and changed with the condition of the sick neonates.Therefore,it could be useful for diagnostic and prognostic marker for neonate septicemia.