脐带血检测在变态反应性疾病预防中的应用

Application of cord blood detection in the prevention of allergic diseases

目的探讨脐带血检测在变应性疾病预防中的作用。方法选择2014年1-4月在首都医科大学附属北京同仁医院分娩的新生儿300例为研究对象，出生后随访42d．根据是否发生新生儿皮疹将105例发生新生儿皮疹的新生儿作为过敏组，195例未发生新生儿皮疹的作为未过敏组。收集脐带血，检测脐带血中T淋巴细胞亚群及其相关细胞因子如白细胞介素-4（IL-4）、γ-干扰素（INF-γ）、白细胞介素-10（IL—10）、白细胞介素～12（IL-12）。分析变态反应性疾病与脐带血中T淋巴细胞亚群及其相关细胞因子的相关性。结果单因素分析结果显示，新生儿出生42d是否发生过敏反应与母亲是否有过敏史、新生儿性别、母亲IgE、抑制T细胞（Ts）％、IL-4／CD4％、IFN／CD4％和Th1／Th2有关（P〈0．05或P〈0．01）；相关性分析结果显示，母亲IgE、总T淋巴细胞、Ts％、IL-4／CD4％、IFN／CD4％、Th1／Th2、喂养方式与生后42d出现过敏具有相关性（P〈0．05或P〈0．01）。多因素回归分析结果显示，母亲有过敏史是危险因素，IFN／CD4、母乳喂养是保护因素（P〈0．01）；IL-4／CD4、IFN／CD4之间ROC曲线下面积分别为0．589和0．433。结论发生变态反应性疾病的新生儿脐带血T淋巴细胞亚群及其相关细胞因子（IL-4、INF-γ、IL-10、IL-12）水平与未发生变态反应性疾病的新生儿存在差异。IL-4／CD4的诊断准确性高于IFN／CD4。

Objective To investigate the application of cord blood detection in the prevention of allergic diseases. Methods Cord blood of 300 neonatal from January to April 2014 in Beijing Tongren Hospital, Capital Medical University was collected, after 42 days of follow-born baby were divided into two groups according to whether with skin rash, 105 newborns with skin rash were as allergic group, 195 newborns without skin rash were as non-allergic group. T lymphocyte subsets and related cytokines such as IL-4, INF-γ, IL-10, IL-12 were detected. Correlation between allergic diseases with T lymphocyte subsets and related cytokines was analyzed. Results Univariate analysis showed that mother allergies, neonatal sex, mother IgE, Ts%,IL-4/CD4%, IFN/CD4% and Th1/Th2 associated with allergic diseases （P 〈 0.05 or P 〈 0.01）; Spearman analysis showed mother IgE, total T lymphocytes, Ts%, IL-4/CD4%, IFN/CD4%, Th1/Th2, feeding associated with allergic diseases （P 〈 0.05 or P 〈 0.01）. Multivariate regression analysis showed mother allergies was risk factor, and IFN/CD4, breastfeeding were protective factors （P 〈 0.01）. A UC of IL-4/CD4 was 0.589 and IFN/ CD4 was 0.433. Conclusion Cord blood T lymphocyte subsets and related cytokines （IL-4, INF-% IL-10, IL-12）of newborn with allergic diseases are different with newborn without allergic diseases. Diagnostic accuracy of IL-4/CD4 is higher than IFN/CD4.