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目的探讨早期早产儿和晚期早产儿合并早发型败血症时的免疫功能特点。方法选择2012年6月至2015年3月广西妇幼保健院新生儿科收治的新生儿,出生24 h内采血进行血常规及免疫功能检查,根据胎龄和感染情况分为早期早产儿败血症组和无感染组、晚期早产儿败血症组和无感染组、足月儿败血症组和无感染组共6组,无感染组按患儿入院先后顺序各纳入100例。检测项目包括血淋巴细胞亚群CD3+、CD4+、CD8+、CD4+/CD8+、CD19+和NK,以及血清Ig G、Ig A、Ig M含量。结果早期早产儿败血症组NK细胞比例高于无感染组,差异有统计学意义(P<0.05);晚期早产儿败血症组CD3+、CD4+、CD19+淋巴细胞比例低于无感染组,NK细胞比例高于无感染组,差异有统计学意义(P<0.05);足月儿败血症组CD3+、CD4+淋巴细胞比例低于无感染组,NK细胞比例高于无感染组,差异有统计学意义(P<0.05)。在合并早发型败血症的不同胎龄新生儿中,早期早产儿CD4+低于晚期早产儿,早期早产儿和晚期早产儿CD3+、CD4+、CD8+、CD19+、NK均低于足月儿,差异有统计学意义(P<0.05);早期早产儿和晚期早产儿Ig G、Ig M低于足月儿。结论早期早产儿和晚期早产儿的适应性免疫和固有免疫特点相似,且在感染时,晚期早产儿免疫功能并不明显优于早期早产儿。
Objective To investigate the immune function of early premature children and late premature children with early-onset sepsis. Methods Newborns admitted to neonatology department of Guangxi Maternal and Child Health Hospital from June 2012 to March 2015 were collected for blood routine examination and immunologic function within 24 hours after birth. According to gestational age and infection, the newborns were divided into sepsis group and no sepsis group Infected group, late premature infant sepsis group and non-infected group, full-term infantile sepsis group and non-infected group, a total of 6 groups, no infection group according to the order of admission of children into the 100 cases. The test items include the blood lymphocyte subsets CD3 +, CD4 +, CD8 +, CD4 + / CD8 +, CD19 + and NK, and serum Ig G, Ig A, Ig M levels. Results The proportion of NK cells in sera of early premature infants was significantly higher than that of non-infected ones (P <0.05). The proportion of CD3 +, CD4 +, CD19 + lymphocytes in sera of late preterm infants was lower than that in non-infants, and the proportion of NK cells was higher (P <0.05). The proportion of CD3 + and CD4 + lymphocytes in full-term infantile sepsis group was lower than that in non-infected group and the proportion of NK cells was higher than that in non-infected group (P <0.05) ). Among the different gestational age neonates with early-onset sepsis, CD4 + levels in early preterm infants were lower than those in advanced preterm infants, while those in early preterm infants and late preterm infants were lower than those in term infants (P <0.05) Significance (P <0.05); Ig G, Ig M in early preterm and late preterm infants were lower than those in term infants. Conclusions The adaptive immunity and innate immunity characteristics of early premature infant and late premature infant are similar, and the immune function of late preterm infants is not obviously better than that of early premature infants when infected.