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目的探讨不同胎龄新生儿感染时T、B、NK细胞及中性粒细胞表面CD分子变化及临床意义。方法2004年2～6月复旦大学儿科医院用流式细胞仪检测34例早产儿及33例足月儿CD表达。结果(1)足月感染组CD3[(76.89±2.52)%]高于足月非感染组[(64.40±5.69)%],早产非感染组[(80.93±9.13)%]高于足月非感染组;早产非感染组CD4[(61.20±2.21)%]高于足月非感染组[(47.60±4.27)%],早产感染组[(53.63±3.23)%]低于早产非感染组;CD8各组间无统计学差异性。(2)CD19各组间无统计学差异性。(3)足月感染组CD56CD16[(5.88±0.62)%]低于非感染组[(13.00±5.31)%],足月非感染组高于早产非感染组[(6.13±1.25)%]。(4)足月感染组CD64[(5056.92±1255.58)分子/单位]高于足月非感染组[(2112.60±1157.21)分子/单位],早产感染组[(4619.67±1395.99)分子/单位]高于早产非感染组[(2407.45±1247.16)分子/单位]。(5)败血症、肺炎及其它感染组CD64高于非感染组。以CD64大于3000分子/单位为阳性,CD64诊断感染灵敏度为79.6%,特异度为75.1%;以CD64大于2000分子/单位为阳性,CD64诊断感染灵敏度为88.9%,特异度为60%;CRP诊断感染灵敏度为65.3%,特异度为86%。结论早产儿细胞表面CD3、CD4、CD16CD56变化不同于足月儿,可能与早产儿免疫功能低下有关;CD64可能会成为一种新型感染诊断指标。
Objective To investigate the changes of CD molecules on T, B, NK cells and neutrophils in neonates with different gestational age and their clinical significance. Methods From February to June 2004, 34 cases of preterm infants and 33 full term infants were detected by flow cytometry in the pediatric hospital of Fudan University. Results (1) CD3 (76.89 ± 2.52)% of full-term infection group was higher than that of non-infected term group (64.40 ± 5.69)%, (80.93 ± 9.13)% of premature non-infected group (61.20 ± 2.21)% in non-infected preterm group were significantly higher than those in non-infected term (47.60 ± 4.27)%, (53.63 ± 3.23)% in preterm labor group, There was no significant difference between CD8 groups. (2) There was no significant difference between CD19 groups. (3) CD56CD16 [(5.88 ± 0.62)%] in term infection group was lower than that in non-infection group (13.00 ± 5.31%), while it was higher in non-infection group than premature non-infection group (6.13 ± 1.25%). (4) The rate of CD64 [(5056.92 ± 1255.58) molecules / unit in term infection group was higher than that in term non-infected group [(2112.60 ± 1157.21) molecules / unit], premature delivery group (4619.67 ± 1395.99 molecule / unit) In premature non-infected group [(2407.45 ± 1247.16) molecules / unit]. (5) CD64 in sepsis, pneumonia and other infected groups was higher than that in non-infected group. CD64 is more than 3000 molecules / unit is positive, CD64 diagnosis of infection with a sensitivity of 79.6%, specificity of 75.1%; with CD64 greater than 2000 molecules / unit is positive, CD64 diagnostic infection sensitivity was 88.9%, specificity was 60%; CRP diagnosis Infection sensitivity was 65.3% and specificity was 86%. Conclusion The changes of CD3, CD4 and CD16CD56 in preterm infants are different from those in term infants, which may be related to the low immunocompromise of premature infants. CD64 may be a new diagnostic indicator of infection.