自然杀伤细胞和神经元特异性烯醇化酶及T淋巴细胞亚群在新生儿化脓性脑膜炎外周血中的表达及临床意义

Expression and clinical significance of natural killer cell cells,neuron specific enolase,CD3^(+),CD4^(+),CD8^(+)in peripheral blood of neonatal suppurative meningitis

目的探讨自然杀伤细胞(NK)、神经元特异性烯醇化酶(NSE)及T淋巴细胞亚群(CD3^(+)、CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+))在新生儿化脓性脑膜炎外周血中的表达及临床意义。方法选取2021年10月至2022年12月赣州市妇幼保健院收治的30例化脓性脑膜炎患儿作为观察组,另选取30名同期出生的健康新生儿作为对照组。两组于入组后次日清晨采集空腹静脉血,观察组治疗后10 d再次采集空腹静脉血。比较两组外周血NK、NSE与T淋巴细胞亚群(CD3^(+)、CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+))水平。结果治疗前,观察组NK、CD3^(+)、CD4^(+)、CD8^(+)水平及CD4^(+)/CD8^(+)均低于对照组,差异有统计学意义(P<0.05);治疗后,观察组NK、CD3^(+)、CD4^(+)、CD8^(+)水平及CD4^(+)/CD8^(+)均高于治疗前,差异有统计学意义(P<0.05),但与对照组比较差异无统计学意义。治疗前,观察组NSE水平高于对照组,差异有统计学意义(P<0.05);治疗后,观察组NSE水平低于治疗前,差异有统计学意义(P<0.05),但与对照组比较差异无统计学意义。ROC曲线分析结果显示,NK诊断价值最高,其次为CD3^(+)、CD4^(+)/CD8^(+)、NSE、CD4^(+)和CD8^(+)。结论新生儿一旦罹患化脓性脑膜炎,会导致外周血中T淋巴细胞紊乱失调,T淋巴细胞免疫功能长时间处于抑制状态,促使脑神经受到不同程度损伤,而通过观察NK细胞、NSE及CD3^(+)、CD4^(+)、CD8^(+)在外周血中的表达,可为临床诊疗提供有力的参考依据,从而改善其免疫功能,有效控制病情,促进患儿病情康复。

Objective To investigate the expression and clinical significance of natural killer cells(NK),neuron specific enolase(NSE)and T lymphocyte subsets(CD3^(+),CD4^(+),CD8^(+),CD4^(+)/CD8^(+))in peripheral blood of neonatal purulent meningitis.Methods 30 children with purulent meningitis admitted to Ganzhou Maternal and Child Health Care Hospital from October 2021 to December 2022 were selected as the observation group,and 30 healthy newborns born in the same period were selected as the control group.Fasting venous blood was collected in the morning of the next day after enrollment in the two groups,and fasting venous blood was collected again in the observation group 10 d after treatment.The levels of NK cells,NSE,and T lymphocyte subsets(CD3^(+),CD4^(+),CD8^(+),CD4^(+)/CD8^(+))in peripheral blood were compared between the two groups.Results Before treatment,the levels of NK,CD3^(+),CD4^(+),CD8^(+)and CD4^(+)/CD8^(+)in the observation group were lower than those in the control group,the differences were statistically significant(P<0.05);after treatment,the levels of NK,CD3^(+),CD4^(+),CD8^(+)and CD4^(+)/CD8^(+)in the observation group were higher than those before treatment,the differences were statistically significant(P<0.05),but there was no significant difference compared with the control group.Before treatment,the level of NSE in the observation group was higher than that in the control group,and the difference was statistically significant(P<0.05);after treatment,the level of NSE in the observation group was lower than that before treatment,and the difference was statistically significant(P<0.05),but there was no significant difference compared with the control group.ROC curve analysis showed that NK cells had the highest diagnostic value,followed by CD3^(+),CD4^(+)/CD8^(+),NSE,CD4^(+)and CD8^(+).Conclusion Once the newborn suffers from purulent meningitis,it will lead to the disorder of T lymphocytes in peripheral blood,and the immune function of T lymphocytes will be inhibited for a long time,which will cause different degrees of damage to the cranial nerves,by observing the expression of NK cells,NSE,CD3^(+),CD4^(+),CD8^(+)and CD4^(+)/CD8^(+)in peripheral blood,it can provide a strong reference for clinical diagnosis and treatment,so as to improve its immune function,effectively control the disease and promote the rehabilitation of children.