新生儿感染T淋巴细胞亚群及细胞因子变化分析

摘要

Objective To study the T Lymphocyte Subsets and the cytokines in the newborns with infectious diseases. Methods Twenty cases of neonatal bacterial pneumonia (bacterial group), 15 cases of rotavirus enteritis (virus group) and 20 newborns with jaundice (control group) were recruited in this study. The peripheral CD4+T Cells and lymphocyte subsets were assessed by flow cytometry. Results The IL-4 level was significantly different among different groups (F=3.39, P=0.041). The levels of IL-17 and IFN-γdid not differ signiifcantly among different groups (F=0.28 and 1.24 respectively, P>0.05). The IL-4 level was higher in bacterial group than that in virus group and control group (P<0.05). The percentages of CD3+, CD4+, CD19+and NK cells and the ratio of CD4+/CD8+ had significant difference among different groups (F=3.30-26.69, P<0.05). The percentages of CD3+and CD4+cells and the ratio of CD4+/CD8+were lower in bacterial group and virus group than those in control group (P<0.05). The percentage of CD19+cells was higher in bacterial group and virus group than that in control group (P<0.05). The percentage of NK cells was lower in virus group than that in bacterial group and control group (P<0.05). Conclusions The pattern of cytokines level is different in newborns with infection caused by different pathogens. Newborns with infectious diseases have immune dysfunction and Th2-dominated imbalance. The low percentages of T lymphocyte subsets indicate the depressed cellular immunity after infection, which may result in atypical symptom and prolonged disease course.%目的：探讨新生儿感染不同病原体后体内相关免疫细胞及其细胞因子的变化。方法入选20例新生儿细菌性肺炎患儿(细菌组)，15例新生儿轮状病毒腹泻患儿(病毒组)，20例新生儿高胆红素血症患儿(对照组)，采用流式细胞仪检测外周血CD4+T淋巴细胞因子、淋巴细胞亚群。结果细菌组、病毒组和对照组间，IL-4水平的差异有统计学意义(F=3.39，P=0.041)，IFN-γ、IL-17水平在三组间的差异均无统计学意义(F=0.28、1.24，P均>0.05)；经两两比较发现，细菌组IL-4水平高于病毒组和对照组，差异有统计学意义(P均<0.05)。除CD8+细胞外，CD3+、CD4+、CD19+、NK细胞阳性率以及CD4+/CD8+，在细菌组、病毒组和对照组三组间的差异均有统计学意义(F=3.30~26.69，P均<0.05)。经两两比较发现，CD3+和CD4+细胞阳性率以及CD4+/CD8+，细菌组和病毒组均低于对照组；细菌组和病毒组CD19+细胞阳性率均高于对照组，差异均有统计学意义(P均<0.05)。病毒组NK细胞阳性率低于对照组和细菌组，差异均有统计学意义(P<0.05)。结论不同病原体感染后体内相关细胞因子水平变化不同，免疫功能紊乱，体内存在Th1/Th2失衡，以Th2型占主导地位。T淋巴细胞亚群水平较低，提示机体感染后细胞免疫功能减低，也可能是新生儿易感及感染后病情隐匿、病程长的原因之一。