围产期窒息和缺氧缺血性脑病红细胞免疫粘附功能及机体免疫状态的研究  

Red cell immune adherence function and organism immune status in perinatal asphyxia and hypoxic ischemic encephalopathy

作　　者：江莲[1] 王素兰[1] 任金荣[1] 戎小平[1] 张雪莉[1] 何兰欣[1] 张晖[1] 

机构地区：[1]河北医科大学第四医院儿科

出　　处：《中国实用儿科杂志》1999年第2期95-97,共3页Chinese Journal of Practical Pediatrics

摘　　要：目的探讨围产期窒息及缺氧缺血性脑病（ＨＩＥ）时机体免疫状态，特别是红细胞免疫状态的变化与ＨＩＥ发病、病理变化及病情演变的关系。方法应用红细胞酵母菌花环试验、间接免疫荧光流式细胞仪检测法、单向免疫扩散法对围产期窒息及ＨＩＥ患儿红细胞免疫粘附（ＲＣＩＡ）功能，血Ｔ细胞亚群、血清免疫球蛋白及补体进行检测。结果窒息及ＨＩＥ组红细胞Ｃ３ｂ受体花环（Ｅ－Ｃ３ｂＲＲ）较对照组明显降低（Ｐ＜００５和＜００１），且随着病情加重降低更为明显。在病情恢复期Ｅ－Ｃ３ｂＲＲ较急性期明显增高（Ｐ＜００５），但仍低于正常组（Ｐ＜００５）。与正常组比较，窒息及ＨＩＥ组ＣＤ３＋、ＣＤ４＋明显降低（Ｐ＜００５），ＣＤ８＋、ＣＤ４＋／ＣＤ８＋无显著变化。ＨＩＥ组血清ＩｇＧ、ＩｇＡ、ＩｇＭ及补体Ｃ３水平明显降低，且Ｅ－Ｃ３ｂＲＲ与ＣＤ８＋呈负相关，与ＣＤ４＋／ＣＤ８＋及ＩｇＭ呈正相关。结论围产期窒息及ＨＩＥ时红细胞及白细胞免疫功能均低下，且两者之间存在显著的相关性，ＲＣＩＡ功能的变化参与了ＨＩＥ的病理生理过程，可间接反映ＨＩＥ时脑损伤的程度及病情演变过程。Objective To study the relationship between the changes of immune status (especially red cell immune status) in perinatal asphyxia and hypoxic ischemic encephalopathy(HIE) and etiology,pathology as well as changes of patient's condition in HIE.Methods Red cell immune adherence (RCIA) function,T-cell and its subsets in peripheral blood,immunoglobulin and complement in serum were detected by erythrocyte saccharomycete rosette test,indirect immune fluorescence staining and flow cytometry and radio immuno-diffusion.Results E-C 3bRR level of asphyxia and HIE groups were lower than that of normal control group(P<0 05 and <0 01).And they were reduced significantly with correlation of exacerbation of the illness.During the recovery period,E-C 3bRR level increased obviously than in acute period(P<0 05),but it was still lower than normal control group(P<0 05).CD 3 + and CD 4 + level decreased in asphyxia and HIE groups as compared with normal control group.IgG,IgA,IgM and complement C 3 of HIE group were lower than normal control group.Negative correlation was observed between E-C 3bRR and CD 8 +.Positive correlation was found between E-C 3bRR and CD 4 +/CD 8 + as well as E-C 3bRR and IgM.Conclusion Red cell immune and white cell immune function are lower in children with perinatal asphyxia and HIE and significant correlation was observed between them.Changes of RCIA function might involve in pathophysiological process of HIE.It may indirectly reflect the degree of brain injury and changes of the disease.

关 键 词：红细胞免疫 新生儿 缺氧缺血性脑病 围产期 

分 类 号：R722.120.2[医药卫生—儿科]