早产儿早期外周血γδ-T等淋巴细胞影响因素及其对近期结局预测的研究

Influencing factors of γδ-T cells in peripheral blood and its predictive value for outcomes in premature infants

目的探讨围生期高危因素对早产儿早期外周血γδ-T等淋巴细胞亚群水平的影响,明确γδ-T细胞对早产儿结局的预测价值。方法选取112例胎龄28~37周的早产儿(包括早期早产儿88例、中晚期早产儿24例)为研究对象,选取同期15例胎龄37~42周的足月儿为对照组,采用流式细胞术检测其生后24 h内外周血γδ-T、CD4+、CD8+、CD3+及总淋巴细胞的比例,分析胎龄及早产高危因素对早期淋巴细胞亚群水平的影响,研究早产儿近期结局与γδ-T等淋巴细胞亚群的关系。结果1)早期早产儿、中晚期早产儿和足月儿外周血γδ-T细胞水平比较,差异有统计学意义(F=8.855,P<0.001),且早期早产儿显著低于其他两组(P<0.05);2)不同早产原因组间各淋巴细胞亚群差异无统计学意义(P>0.05);3)不同医源性早产原因的4个亚组间γδ-T细胞水平差异有统计学意义(F=3.595,P<0.05),且胎儿生长受限组患儿γδ-T细胞比例降低(P<0.05);4)γδ-T等淋巴细胞亚群分布在早发型感染组与无早发型感染组间差异无统计学意义(P>0.05);5)矫正胎龄6月龄和12月龄时,早产儿发育正常组、脑瘫/发育落后组和死亡组外周血中γδ-T等淋巴细胞亚群水平差异无统计学意义(P>0.05)。结论早产儿早期外周血γδ-T细胞主要受胎龄影响,并对胎儿生长受限敏感,与早产儿近期发育水平无显著相关性。

Objective To investigate the influence of perinatal risk factors onγδ-T lymphocyte subsets in peripheral blood of preterm infants,and to determine the prognostic value ofγδ-T cells for outcomes of premature infants.Methods A total of 112 preterm infants with gestational age from 28 to 37 weeks were enrolled in this study(including 88 cases of early preterm infants,24 cases of middle to late preterm infants).Meanwhile 15 infants with gestational age of 37 to 42 weeks were selected into the control group.The levels ofγδ-T,CD4+,CD8+,CD3+and total lymphocytes in peripheral blood within 24 hours after birth were tested by flow cytometry.The influence of gestational age and risk factors of preterm birth on the lymphocyte subsets levels,as well as the relationship between outcomes of premature infants andγδ-T cells were analyzed.Results 1)There was significantly difference in the level ofγδ-T cell in peripheral blood among the early preterm infants,middle to late preterm infants and term infants(F=8.855,P<0.001),and the proportion ofγδ-T cells in early preterm infants was significantly lower than that in the other two groups(P<0.05).2)There was no significant difference in lymphocyte subsets among different causes of preterm birth groups(P>0.05).3)The levels ofγδ-T cells in the four different iatrogenic preterm delivery subgroups were significantly different(F=3.595,P<0.05),andthe proportion ofγδ-T cells in the fetal growth restriction group was significantly decreased(P<0.05).4)There was no significant difference in the proportion of lymphocyte subsets between early-onset infection group and non-early-onset infection group(P>0.05).5)No significant difference inγδ-T lymphocyte subsets was found among the normal group,the cerebral palsy/developmental delays group and the death group with 6 and 12 months of corrected age(P>0.05).Conclusionγδ-T cells in early peripheral blood of preterm infants are mainly affected by gestational age and are sensitive to fetal growth restriction,but have no correlation with the short-term development level of preterm infants.