Th1/Th2漂移与新生儿呼吸窘迫综合征疾病严重程度的关系  

Relationship Between Th1/Th2 Shift and Disease Severity in Children with Neonatal Respiratory Distress Syndrome

作　　者：惠晓君 齐玉敏[1] 田静 王品 陈克云 HUI Xiaojun;QI Yumin;TIAN Jing;WANG Pin;CHEN Keyun(Department of Neonatology,Nanyang Central Hospital,Nanyang 473000,China)

机构地区：[1]南阳市中心医院新生儿科,河南南阳473000

出　　处：《河南医学研究》2025年第1期55-59,共5页Henan Medical Research

摘　　要：目的探究辅助性T细胞1/辅助性T细胞2(Th1/Th2)漂移与新生儿呼吸窘迫综合征(NRDS)疾病严重程度关系。方法选取2018年1月至2021年3月收治的117例NRDS患儿,分为轻度组62例与重度组55例。比较两组治疗前Th1细胞及Th2细胞表达率、Th1/Th2值、病情危重情况、呼吸功能参数[动脉氧分压(PaO_(2))、二氧化碳分压(PaCO_(2))、氧合指数(OI)、动脉-肺泡氧分压比例(PaO_(2)/PAO_(2))];采用Pearson相关分析法评价Th1/Th2值与NCIS得分、呼吸功能参数相关性。根据患儿接受规范诊治后预后情况分为预后良好组、预后不良组,观察预后良好组、预后不良组治疗不同时间点Th1/Th2值变化;绘制受试者工作特征(ROC)曲线评价Th1/Th2值对患儿预后预测价值。结果(1)重度组治疗前外周血Th1、Th1/Th2值均较轻度组升高(P<0.05);(2)重度组NCIS得分低于轻度组,呼吸功能参数中PaO_(2)、PaO_(2)/PAO_(2)较轻度组下降,PaCO_(2)、OI较轻度组升高(P<0.05);(3)Pearson相关性分析显示,Th1/Th2值与NCIS得分、PaO_(2)均呈负相关(r=-0.312,-0.404,P<0.05),与PaCO_(2)、OI均呈正相关(r=0.228,0.276,P<0.05),与PaO_(2)/PAO_(2)无明显相关性(P>0.05);(4)117例患儿中25例出现预后不良,且重度组预后不良率高于轻度组(P<0.05);(5)预后良好组治疗前和治疗后1、3 d外周血Th1/Th2值均低于预后不良组,但预后不良组末次检测时外周血Th1/Th2值低于预后良好组;(6)治疗前Th1/Th2值预测患儿预后不良的ROC曲线下面积(AUC)为0.835。结论Th1/Th2漂移与NRDS患儿病情严重程度、呼吸功能具有相关性,且对患儿预后有一定预测价值。Objective To explore the relationship between T helper 1/T helper 2(Th1/Th2)shift and severity of disease in children patients with neonatal respiratory distress syndrome(NRDS).Methods A total of 117 children patients with NRDS admitted between January 2018 and March 2021 were selected and divided into mild group(62 cases)and severe group(55 cases).The expression rates of Th1 cells and Th2 cells before treatment,and the Th1/Th2 value,critical disease condition and respiratory function parameters[arterial partial pressure of oxygen(PaO_(2)),partial pressure of carbon dioxide(PaCO_(2)),oxygenation index(OI),PaO_(2)/alveolar partial pressure of oxygen(PaO_(2)/PAO_(2))]were compared between the two groups.Pearson correlation analysis method was used to evaluate the correlation between Th1/Th2 value and NCIS score and respiratory function parameters.According to the prognosis status of children patients receiving standardized diagnosis and treatment,they were divided intogood prognosis group and poor prognosis group.The changes in Th1/Th2 value were observed ingood prognosis group and poor prognosis group at different time points of treatment.Receiver operating characteristic(ROC)curve was drawn to evaluate the predictive value of Th1/Th2 value on prognosis of children patients.Results(1)The peripheral blood Th1 level and Th1/Th2 in severe group were higher compared to mild group before treatment(P<0.05).(2)The NCIS score of severe group was significantly lower than that of mild group.The respiratory function parameters of PaO_(2)and PaO_(2)/PAO_(2)were decreased compared with those in mild group while the PaCO_(2)and OI were increased compared to mild group(P<0.05).(3)Pearson correlation analysis showed that Th1/Th2 value was negatively correlated with NCIS score and PaO_(2)(r=-0.312,-0.404,P<0.05),and was positively correlated with PaCO_(2)and OI(r=0.228,0.276,P<0.05),but was not significantly correlated with PaO_(2)/PAO_(2)(P>0.05).(4)Twenty-five of the 117 children were with poor prognosis in the hospital,and the

关 键 词：新生儿呼吸窘迫综合征 辅助性T细胞 TH1/TH2细胞失衡 疾病严重程度 预后 

分 类 号：R722[医药卫生—儿科]