酪酸梭菌二联活菌对晚期早产儿外周血T细胞表达CD28和PD-1的影响及临床意义

Effects of clostridium butyricum and bifidobacterium on the expression of PD-1 and CD28 in T lymphocytes in late preterm infants and their clinical significance

目的研究晚期早产儿在酪酸梭菌二联活菌治疗前后外周血T细胞表达PD-1和CD28差异;探讨酪酸梭菌二联活菌对晚期早产儿免疫功能影响及临床意义。方法选取新生儿重症监护室的晚期早产儿40人,按随机分组法平均分为两组(实验组和对照组),最终对照组18例、实验组17例完成试验。实验组服用酪酸梭菌二联活菌(溶于奶粉溶液);对照组仅服用相同剂量的奶粉溶液。分别于入院时(生后24小时内)和干预7天后抽取患儿外周静脉血。流式细胞仪检测CD4+与CD8+T细胞上PD-1和CD28表达量。同时检测患儿入院时的生化指标,观察生化指标与PD-1、CD28表达的相关性。结果 (1)相对于对照组,实验组在酪酸梭菌二联活菌治疗后,CD8+T细胞上PD-1表达更高(P=0.0262);(2)相对于对照组,实验组在酪酸梭菌二联活菌治疗前后,其CD4+T细胞PD-1的表达的下降幅度(治疗后与治疗前的比值)和CD28的表达的上升幅度均显著增高(P=0.0318;P=0.00380);(3)所有晚期早产儿(对照组和实验组)在酪酸梭菌二联活菌治疗前,其CD8+T细胞上PD-1表达与血清白蛋白呈负相关(r=-0.5097,P=0.0018),而其CD28表达与血清球蛋白呈正相关(r=0.5699,P=0.0004)。结论 (1)酪酸梭菌二联活菌治疗影响晚期早产儿T细胞上PD-1和CD28表达;(2)酪酸梭菌二联活菌治疗有助于改善晚期早产儿的免疫功能。

Objective To study the difference of PD-1 and CD28 expression in peripheral blood T lymphocytes before and after treatment of clostridium butyricum and bifidobacterium in late preterm infants;To explore the effect of clostridium butyricum and bifidobacterium on immune function and their clinical significance in late preterm infants.Methods 40 late preterm infants in the neonatal intensive care unit were selected and divided into two groups equally according to the random grouping method,among which all experimental steps were completed successfully in 18 cases in the control group and 17 cases in the experimental group respectively.The experimental group took clostridium butyricum and bifidobacterium which was dissolved in milk powder solution twice a day,but the control group only received the same dose of milk powder solution.Peripheral venous blood of the infant was extracted in the first day during24 hours after admission and 7 days later after intervention.The expression levels of PD-1 and CD28 on CD4+and CD8+T cells were measured by flow cytometry.At the same time,the biochemical indexes were detected in the first day during 24 hours after admission,and the correlation between clinical indexes and the expression of PD-1 and CD28 was analyzed.Results Compared with control group,the expression of PD-1 in CD8+T was higher in test group after treatment(P=0.0262).Compared with the control group,PD-1 in the experimental group showed a larger decrease amplitude(the ratio of PD-1 before and after treatment),while CD28 showed a significant increase amplitude(P=0.0318;P=0.0038 respectively).Albumin was shown negatively correlated with PD-1 expression(r=-0.5097,P=0.0018),but globulin is positively correlated with CD28 expression(r=0.5699,P=0.0004)on CD8+T cells in the first day during 24 hours after admission.Conclusion Clostridium butyricum and bifidobacterium treatment could influence PD-1 and CD28 expression on T lymphocytes.Clostridium butyricum and bifidobacterium treatment might improve immune function in late preterm infants.