缺氧缺血性脑病新生儿T淋巴细胞亚群、内皮素的变化

Changes of T lymphocyte subgroups and ET-1 in newborn infants with hypoxic ischemic encephalopathy

目的观察新生儿缺氧缺血性脑病(HIE)新生儿全血T淋巴细胞亚群(CD4+/CD8+)、血浆内皮素(ET-1)的水平变化,探讨其在HIE中的临床意义。方法足月HIE患儿59例(轻度12例,中度30例,重度17例)及35例健康足月新生儿(健康对照组)出生72h取静脉血,采用流氏细胞仪检测全血CD4+/CD8+及放射免疫法检测血浆ET-1,比较各组间的差异;并分析HIE组CD4+/CD8+与ET-1水平的相关性。结果 1.HIE组CD4+/CD8+比值显著低于健康对照组,HIE组ET-1水平显著高于健康对照组(P均<0.01);2.HIE各组CD4+/CD8+比值随HIE程度加重而降低、ET-1水平随HIE程度加重而增加,各组间差异均有统计学意义(P均<0.05);3.HIE组患儿CD4+/CD8+、ET-1水平呈显著负相关(r=-0.847,P<0.05)。结论 CD4+/CD8+和ET-1水平可作为HIE新生儿病情严重程度和疗效判断的早期指标。

Objective： To explore the changes of T lymphocyte subgroups （CD4＋/CD8＋） and ET-1 and evaluate the clinical value in newborn infants with hypoxic-ischemic encephalopathy. Methods： 59 new born infants met the criteria for HIE. There are 12 cases in mild HIE group, 30cases in moderate HIE group and 17 cases in severe HIE group, 35 cases normal newborn infants were used as control group. Withdraw blood from veins in each group at 72 hours after borning, the percentage of T-lymphocyte subgroups （CD4＋/CD8＋） were determined by flow cytometry, the level of ET-1 were detected using radioimmunoassay. Compare differences between the groups and do correlation analysis between T lymphocyte subgroups and ET-1 in HIE group. Results： 1. CD4＋/CD8＋ level of HIE group were lower than that of control group （P〈0.01） , the ET-1 level of HIE group were higher than that of control group （P〈0.01） ; 2. The CD4＋/CD8＋ level of HIE groups decreased with severity of disease state of HIE （P〈0.05） ; The ET-1 level of HIE groups increased with severity of disease state of HIE （P〈0.05） ： 3. The level of CD4＋/ CD8＋ were negatively correlated with that of ET-1 in HIE group （r=-0.847, P〈0.05） . Conclusion： T lymphocyte subgroups and ET-1 level can be used as criteria of disease severity and observing effect of treatment in early phase of HIE.