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目的为探讨新生儿缺氧缺血性脑病(HIE)T细胞亚群及细胞因子变化的临床意义。方法分别用APAAP法、双抗体夹心ELISA法于生后第1d(24h内)、7d检测了49例HIE患儿及20例正常新生儿的外周血T细胞亚群、血清白细胞介素-2(IL-2)、白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)的变化。结果HIE患儿与正常新生儿比较,生后第1dCD3分别为(59.35±9.51)对(63.10±6.30)%(P<0.5),CD4分别为(34.75±6.38)对(46.75±6.54)%(P<0.01),CD8分别为(24.90±3.63)对(23.20±4.42)%(P<0.5),CD4/CD8比值分别为1.37±0.38对2.32±0.40(P<0.01),IL-2分别为(13.60±2.87)对(57.20±4.37)ng/L(P<0.01),IL-6分别为(57.44±3.75)对(76.01±17.71)ng/L(P<0.01),TNF-α分别为(1.45±0.21)对(1.03±0.12)μg/L(P<0.01),而且病情越重改变越明显。至生后1周,CD3、CD4、CD8及各上述各细胞因子水平均逐渐恢复,但仍未达正常对照水平。结论提示细胞免疫功能紊乱及细胞因子变化与HIE的发病及脑损害过程有关。本研究为HIE的免疫学诊断及治疗提供了理论依据。
Objective To investigate the clinical significance of T cell subsets and cytokines in neonates with hypoxic-ischemic encephalopathy (HIE). Methods The peripheral blood T lymphocyte subsets of 49 HIE infants and 20 normal neonates were detected by APAAP method and double antibody sandwich ELISA on the 1st day (24h) and 7th day after birth. Serum interleukin - 2 IL-2, IL-6 and TNF-α were measured. Results Compared with the normal newborns, the CD3 in the HIE children were (59.35 ± 9.51) vs (63.10 ± 6.30)% (P <0.5) on the first day and 46.75 ± 6.54% (34.75 ± 6.38) vs. (24.90 ± 3.63) vs (23.20 ± 4.42)% (P <0.5), and the ratio of CD4 / CD8 was 1.37 ± 0.38 vs 2.32 ± 0.40 (P <0.01) (57.64 ± 3.75) vs (76.01 ± 17.71) ng / L, respectively (P <0.01). The levels of TNF-α were (13.60 ± 2.87) vs (57.20 ± 4.37) ng / (1.45 ± 0.21) vs (1.03 ± 0.12) μg / L (P <0.01), and the more severe the disease was, the more obvious the changes were. One week after birth, the levels of CD3, CD4, CD8 and various cytokines gradually recovered, but still not reached the level of normal control. Conclusions suggest that cellular immune dysfunction and cytokine changes and HIE pathogenesis and brain damage process. This study provides a theoretical basis for the immunological diagnosis and treatment of HIE.