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目的探讨晚期早产儿外周血淋巴细胞亚群和体液免疫指标的特点。方法选择2012年6月至2013年6月在我院产科出生并除外窒息、感染、免疫缺陷等疾病的晚期早产儿(胎龄34~36周)为观察组,选择同期的早期早产儿(胎龄<34周)和足月儿(胎龄37~42周)为对照组。所有新生儿均于生后24 h内检测外周血T淋巴细胞亚群分布情况及体液免疫水平。结果符合纳入标准的新生儿共203例,早期早产儿组、晚期早产儿组和足月儿组分别为57例、58例和88例。早期早产儿和晚期早产儿生后24 h内外周血CD3+、CD4+、CD8+及CD4+/CD8+均低于足月儿[CD3+:(47.3%±6.9%)、(60.6%±7.7%)比(73.8%±8.4%),CD4+:(27.1%±5.5%)、(37.1%±9.1%)比(50.8%±6.1%),CD8+:(14.9%±5.7%)、(17.9%±4.4%)比(21.4%±3.8%),CD4+/CD8+:(1.8±0.5)、(2.1±0.3)比(2.5±0.7),P<0.05],晚期早产儿高于早期早产儿(P<0.05)。早期早产儿和晚期早产儿IgG、IgM均低于足月儿[IgG:(5.33±3.05)、(8.81±2.97)比(12.65±2.21),IgM:(0.23±0.07)、(0.31±0.14)比(0.45±0.12),P<0.05],晚期早产儿高于早期早产儿(P<0.05);各组IgA水平差异无统计学意义(P>0.05)。结论晚期早产儿的T淋巴细胞亚群水平和体液免疫功能较早期早产儿有所提高,但仍低于健康足月儿,临床工作中应重视对晚期早产儿的护理和预防感染。
Objective To investigate the characteristics of peripheral blood lymphocyte subsets and humoral immunity in late preterm children. Methods From June 2012 to June 2013 in our hospital obstetrics and gynecology and exclusion of diseases such as asphyxia, infection, immune deficiency and other diseases of late preterm children (gestational age 34 to 36 weeks) as the observation group, select the same period of early premature children (fetal Age <34 weeks) and full-term children (gestational age 37 to 42 weeks) as the control group. All newborns were detected within 24 h after birth, T lymphocyte subsets in peripheral blood distribution and humoral immunity levels. Results A total of 203 newborns who met the inclusion criteria were 57, 58 and 88 respectively in the early premature infant group, the late preterm infant group and the full-term infant group. CD3 +, CD4 +, CD8 + and CD4 + / CD8 + were lower in preterm infants and late preterm infants within 24 hours after birth than those in infants (47.3% ± 6.9%, 60.6% ± 7.7%, 73.8% CD4 +: (27.1% ± 5.5%), (37.1% ± 9.1%) vs. 50.8% ± 6.1%, CD8 + :( 14.9% ± 5.7% (21.4% ± 3.8%), CD4 + / CD8 +: (1.8 ± 0.5), (2.1 ± 0.3) vs (2.5 ± 0.7), P <0.05. The levels of IgG and IgM in early preterm and late preterm infants were lower than those in full - term infants [IgG: (5.33 ± 3.05), (8.81 ± 2.97) vs (12.65 ± 2.21), IgM: (0.23 ± 0.07), (0.31 ± 0.14) (0.45 ± 0.12), P <0.05]. The level of IgA in each group was no significant difference (P> 0.05). Conclusion The level of T lymphocyte subsets and humoral immune function in advanced preterm infants are higher than those in early infants but still lower than those in healthy term infants. The clinical work should pay attention to the nursing and prevention of infection in advanced preterm infants.