新生儿缺氧缺血性脑病红细胞免疫功能的变化及其影响因素

目的了解新生儿缺氧缺血性脑病(hypoxic-ischemicencephalopathy,HIE)的红细胞免疫功能状态及各种因素对其的影响。方法采用郭峰红细胞酵母花环法对73例HIE检测红细胞C3b受体花环率(RBC-C3bRR)、红细胞免疫复合物花环率(RBC-ICR),并与104例正常新生儿进行对照。结果①HIE患儿的RBC-C3bRR低于正常对照组,其RBC-ICR高于对照组,差异有显著性(P<0.01);②中、重度HIE患儿的RBC-C3bRR低于轻度HIE患儿(P<0.01);不同程度的HIE患儿间RBC-ICR差异无显著性;③HIE伴出血、硬肿症患儿的RBC-ICR增高,而RBC-C3bRR差异无显著性。④HIE患儿的红细胞免疫功能与性别、胎龄、日龄、脐带、羊水、Apgar评分等因素无明显相关性。结论新生儿HIE的红细胞免疫功能低下,而且HIE病情程度越严重,红细胞免疫功能低下越明显。     

兰州地区新生儿红细胞免疫功能测定及其影响因素分析

目的了解兰州地区新生儿红细胞免疫功能状态,同时观察相关因素如性别、胎龄、日龄、出生体重、喂养方式、有无黄疸等对新生儿红细胞免疫功能的影响.方法采用郭峰红细胞酵母花环法测定104例新生儿红细胞C3b受体花环率(RBC-C3bRR)和红细胞免疫复合物受体花环率(RBC-ICR).结果①正常新生儿RBC-C3bRR为(16.80±1.56)%,RBC-ICR为(5.72±1.63)%.②不同性别、胎龄、日龄、出生体重间比较,RBC-C3bRR和RBC-ICR无明显差别;母乳喂养与混合喂养新生儿比较,RBC-C3bRR和RBC-ICR均有差别,P＜0.05;而母乳喂养与配方奶喂养、配方奶喂养与混合喂养比较,RBC-C3bRR和RBC-ICR则无显著性差别;有无生理性黄疸新生儿之间比较,RBC-ICR有显著性差别;而RBC-C3bRR无明显差异.③相关分析表明,RBC-C3bRR与出生体重、喂养方式相关,P＜0.05;RBC-ICR与喂养方式、生理性黄疸等因素相关,P＜0.05;RBC-C3bRR和RBC-ICR与性别、胎龄、日龄等各种因素无明显关系.结论新生儿红细胞免疫功能与某些因素有着密切关系,这些因素对新生儿红细胞免疫功能有一定的影响.     

兰州地区新生儿红细胞免疫功能测定及其影响因素分析

目的了解兰州地区新生儿红细胞免疫功能状态,同时观察相关因素如性别、胎龄、日龄、出生体重、喂养方式、有无黄疸等对新生儿红细胞免疫功能的影响。方法采用郭峰红细胞酵母花环法测定104例新生儿红细胞C3b受体花环率(RBC-C3bRR)和红细胞免疫复合物受体花环率(RBC-ICR)。结果①正常新生儿RBC-C3bRR为:(16．80±1．56)％,RBC-ICR为:(5．72± 1．63)％。②不同性别、胎龄、日龄、出生体重间比较,RBC-C3bRR和RBC-ICR无明显差别;母乳喂养与混合喂养新生儿比较,RBC-C3bRR和RBC-ICR均有差别,P<0．05;而母乳喂养与配方奶喂养、配方奶喂养与混合喂养比较,RBC-C3bRR和RBC-ICR则无显著性差别;有无生理性黄疸新生儿之间比较,RBC-ICR有显著性差别;而RBC-C3bRR无明显差异。③相关分析表明,RBC-C3bRR 与出生体重、喂养方式相关,P<0．05;RBC-ICR与喂养方式、生理性黄疸等因素相关,P<0．05; RBC-C3bRR和RBC-ICR与性别、胎龄、日龄等各种因素无明显关系。结论新生儿红细胞免疫功能与某些因素有着密切关系,这些因素对新生儿红细胞免疫功能有一定的影响。     

高胆红素血症新生儿红细胞免疫功能的变化及其影响因素

目的研究高胆红素血症新生儿的红细胞免疫功能状态，观察各种因素对红细胞免疫功能的影响。方法采用酵母多糖花环试验法对52例高胆红素血症新生儿测定红细胞C3b补体受体花环（RBC-C3bRR）和红细胞免疫复合物受体花环（RBC-ICR），并与104例正常新生儿进行对比。结果1．高胆红素血症患儿RBC-C3bR低于正常新生儿，而RBC-ICR则高于正常新生儿，差异有显著性（Pa〈0．01）；2．不同总胆红素水平的新生儿间比较，RBC-C3bRR无统计学差异（Pa〉0．05），RBC-ICR有显著性差异（Pa〈0．05）；3．不同血清未结合胆红素水平的高胆红素血症患儿间进行比较，RBC-ICR有显著性差异（Pa〈0．05），RBC-C3bRR无明显差异（Pa〉0．05）；4．相关分析表明，高胆红素血症患儿的RBC-ICR与总胆红素、未结合胆红素水平间呈显著正相关（Pa〈0．05）；RBC-C3bRR与光疗时间呈正相关（P〈0．05）；高胆红素血症患儿的红细胞免疫功能与胎龄、日龄、喂养方式等因素无明显相关性（Pa〉0．05）。结论新生儿高胆红素血症的红细胞免疫功能低于正常新生儿，并与血清胆红素水平及光疗时间的影响有关。     

血清胆红素对红细胞免疫功能的影响

目的 了解胆红素对红细胞免疫功能的影响。方法 对38例黄疸患儿进行胆红素和红细胞免疫功能检测,红细胞C3b补体受体花环(RBC-C3bRR)和红细胞免疫复合物受体花环(RBC-ICR)采用酵母多糖花环试验,血清胆红素采用苯甲酸尿素比色法。结果 发现该组患儿RBC-C3bRR,红细胞辅助因子(RIER)明显降低,而RBC-ICR,红细胞抑制因子(RIFR)明显升高,并发现RBC-C3bRR,RIER与胆红素浓度呈负相关,RBC-ICR,RIFR与胆红素浓度呈正相关。结论 血清胆红素能引起继发性红细胞免疫功能低下。     

脑创伤患儿红细胞免疫功能的变化

目的探讨小儿脑创伤后红细胞免疫功能改变的意义。方法选取脑创伤患儿60例,按伤情分为轻型损伤和中重型损伤组。选取腹腔沟疝、隐睾各15例为对照组。酵母菌花环法检测其血红细胞C3b受体花环率(RBC-C3bRR)和红细胞免疫复合物花环率(RBC-ICR),放射免疫法测定其血清β-内啡肽(β-EP)水平,并对数据进行统计学分析。结果与对照组比较,脑创伤患儿组RBC-C3bRR明显下降(P<0.01),RBC-ICR和β-EP均明显升高(Pa<0.01);中重型创伤组各指标改变较轻型创伤组更明显(Pa<0.05)。脑创伤患儿β-EP变化与RBC-C3bRR呈直线负相关[r(轻型组)=-0.865;r(中重型)=-0.635Pa<0.05];β-EP变化与RBC-ICR呈直线正相关[r(轻型组)=0.644;r(中重型)=0.746Pa<0.05]。结论脑创伤患儿红细胞免疫功能明显下降,其改变与体内β-EP明显升高密切相关。     

支气管哮喘患儿红细胞免疫粘附肿瘤细胞能力的研究

目的：探讨支气管哮喘患儿自然条件下的红细胞免疫功能和免疫粘附肿瘤细胞的能力。方法：红细胞C3b受体花环率(RBC-C3bRR)、红细胞CIC受体花环率(RBC-ICRR)采用酵母菌花环试验。红细胞免疫粘附肿瘤细胞(RIT)采用C3b介导的免疫粘附实验。结果：支气管哮喘患儿RBC-C3bRR、RIT明显降低,RBC-ICRR明显升高。与对照组比较差异有显著性意义,均P<0.01。结论：支气管哮喘患儿红细胞免疫功能低下,红细胞膜受体活性在支气管哮喘患儿气道炎症中可能起到重要作用,可作为临床监测支气管哮喘病情的一个可靠指标。     

毛细支气管炎患儿红细胞免疫及T细胞亚群变化的研究

目的：探讨毛细支气管炎患儿红细胞免疫和T细胞亚群的变化及意义。方法：对45例毛细支气管炎患儿和30例正常儿童的红细胞免疫功能和T细胞亚群进行检测。检测外周血红细胞免疫复合物花环率（RBC-ICR）、红细胞C3b受体花环率（RBC-C3bRR）;采用流式细胞术检测CD3+、CD4+、CD8+细胞亚群。结果：毛细支气管炎患儿RBC-C3bRR［（13.6±6.2）%］、CD8+细胞百分比［（21.6±4.4）%］ 较对照组的（18.0±7.4）% 和 (25.6±5.2)%减低（P<0.01）;CD3+［（59.9±6.7）%］和CD4+细胞百分比［（53.5±6.2）%］及RBC-ICR［（8.3±3.5）%］均高于对照组的（52.1±8.3）%、（46.8±4.9）% 和（6.1±2.5）%（P<0.01）。毛细支气管炎患儿RBC-ICR和CD4+细胞百分比存在正相关（r=0.63,P<0.05）,RBC-C3bRR和CD4+细胞百分比存在负相关（r=-0.82,P<0.01）。结论：毛细支气管炎患儿存在T淋巴细胞、红细胞免疫功能障碍,可能在毛细支气管炎的发病机制中起到一定作用。     

儿童乙肝病毒相关性肾炎红细胞免疫功能检测结果

目的：研究红细胞免疫功能与乙肝病毒相关性肾炎(HBVMN)的关系。方法：采用酵母菌花环法测定了8例经肾活检证实的HBVMN患儿及12健康儿童(对照组)的红细胞C3b(RBC-C3b)受体花环率及红细胞免疫复合物(RBC-IC)花环率,并进行比较。结果：HBVMN组RBC-C3b受体花环率(11.2±2.3)%明显低于对照组(17.2±3.2)%,(P<0.01)。RBC-IC花环率(11.2±2.0%)明显高于对照组(4.7±1.2),(P<0.05)。结论：HBVMN患儿红细胞粘附功能明显低下,提示其清除免疫复合物能力不足,免疫复合物易于沉积而诱发HBVMN。     

恶性肿瘤患儿红细胞免疫功能的检测

目的探讨恶性肿瘤患儿红细胞免疫功能的变化。方法用花环试验检测恶性肿瘤患儿红细胞免疫功能。结果与正常儿童或良性肿瘤患儿相比,恶性肿瘤患儿RBC-C3b受体花环率及促进率显著降低(P<0.01);RBCIC花环率及RBC-C3b受体花环抑制率显著升高(P<0.01);4项肿瘤红细胞花环试验指标均显著降低(P<0.05或P<0.01)。结论恶性肿瘤患儿红细胞免疫功能是低下的,红细胞免疫功能的检测对于探讨小儿恶性肿瘤的发病机理和治疗措施具有一定的意义。     

贫血患儿红细胞免疫功能观察

为了解贫血患儿的红细胞免疫功能,对 ８５例贫血患儿（缺铁性贫血 ２９例、急性白血病 ２６例、地中海贫血 １８例、再生障碍性贫血 １２例）进行了红细胞 Ｃ３ｂ受体花环率（ＲＢＣ－Ｃ３ｂＲＲ）和红细胞免疫复合物花环率（ＲＢＣ－ＩＣＲ）测定。结果显示所有贫血患儿ＲＢＣ－Ｃ３ｂＲＲ均显著低于对照组儿童（Ｐ＜０．０１）,缺铁性贫血和再生障碍性贫血患儿 ＲＢＣ－ＩＣＲ与对照组比较无明显差异（Ｐ＞０．０５）,急性白血病患儿 ＲＢＣ－ＩＣＲ高于对照组（Ｐ＜０．０５）,地中海贫血患儿 ＲＢＣ－ＩＣＲ则显著高于对照组（Ｐ＜０．０１）。贫血患儿容易感染可能与红细胞免疫功能低下有关。     

川崎病患儿红细胞补体受体1数量基因多态性及红细胞免疫的变化

目的了解川崎病患儿外周血红细胞补体受体1(ECR1)分子在川崎病急性期及恢复期的表达,初步探讨红细胞免疫功能与ECR1数量基因多态性的相关性。方法分别采用红细胞C3b受体花环率和红细胞免疫复合物花环率,并利用聚合酶链反应-限制性片段长度多态性(PCR-RFLP)方法检测30例川崎病患儿(病例组)和28例健康儿童(对照组)的ECR1活性与ECR1数量基因多态性并进行比较。结果病例组患儿急性期红细胞C3b受体花环率低于对照组(P<0.01),恢复期病例组红细胞C3b受体花环率仍低于对照组(P<0.05),而红细胞免疫复合物花环率则接近对照组(P>0.05)。川崎病患儿HL和LL基因型的分布频率高于正常儿童(P<0.01),两组CR1等位基因的分布频率差异也有统计学意义,川崎病患儿L等位基因的分布频率明显高于正常儿童(P<0.01)。结论川崎病患儿急性期存在红细胞免疫功能低下,这是患儿CR1数量基因呈中低度表达所致,提示CR1基因的多态性可能在决定个体川崎病遗传易感性方面有重要作用。     

Perinatal changes of brain-derived neurotrophic factor in pre- and fullterm neonates

BACKGROUND: Brain-derived neurotrophic factor (BDNF) is abundant in brain and peripheral nerves, affects normal development, growth and survival and is implicated in immune response. AIM: To determine in single preterm (P) and fullterm (F) neonates, circulating intra- and extrauterine levels of BDNF, supposingly reflecting their neuronal and immune maturity. STUDY DESIGN: Prospective study. SUBJECTS: Thirty healthy, appropriate for gestational age (AGA) F (mean gestational age 39.2+/-1.4 weeks), 15 healthy AGA P (29.4+/-1.3 weeks), and their mothers. OUTCOME MEASURES: BDNF was measured by enzyme immunoassay methods in the serum of: mothers at the first stage of labor (MS), the umbilical cord (UC) and the neonates on days 1 (N1) and 4 (N4) postpartum. RESULTS: Levels of BDNF in (a). FMS did not differ from PMS, but both were significantly higher than respective (F or P) UC, N1 and N4 (p ranging from <0.01 to <0.001), (b). FUC, FN1 and FN4 were significantly higher than PUC (p<0.001), PN1 (p<0.03) and PN4 (p<0.02), respectively, (c). PN1 increased significantly as compared to PUC (p<0.05). CONCLUSIONS: Higher BDNF MS levels may reflect the mature nervous and immune systems of mothers. Higher BDNF levels in F than P may also be due to advanced maturity in the former. Increased BDNF levels in PN1 as compared to PUC may indicate stimulation of immune response with exposure to antigenic stimuli from the extrauterine environment. Nevertheless, this stimulation is insufficient in P, who by decreasing N4 levels are by far less protected than F.     

先天性甲状腺功能低下症对新生儿左心功能的影响

目的　评价先天性甲状腺功能低下症 (CH)新生儿的左心收缩和舒张功能变化 ,并探讨其与血甲状腺激素水平的相关性。方法　对 35例确诊为CH的新生儿和 30例正常新生儿进行超声心动图检查 ,分别用M型超声心动图测量左室射血分数 (LVEF)、左室短轴缩短率 (LVFS) ;脉冲多普勒 (PWD)测量二尖瓣口血流舒张早期峰值速度 (Em)、二尖瓣口血流舒张晚期峰值速度 (A m) ;定量组织速度成像 (QTVI)测量二尖瓣环收缩期运动峰值速度 (sm)、二尖瓣环舒张早期运动峰值速度 (em)、二尖瓣环舒张晚期运动峰值速度 (am) ;组织追踪显像 (TTI)测量收缩期二尖瓣环下移距离 (MAD) ,并对血甲状腺激素水平和心功能指标行相关性分析。结果　两组间收缩功能指标LVEF、LVFS、sm、MAD及舒张功能指标Am、Em/Am、、em/am、、Em、em 差异均有显著性意义 (P <0 0 5 ) ,其中两组间MAD、sm、Em、em 差异有极显著性意义 (P <0 0 0 1)。心脏收缩功能指标LVEF、sm、MAD及舒张功能指标Em、Am、em、em/am 与TT3 、TT4呈正相关 (P <0 0 5 ) ,与TSH呈负相关 (P <0 0 5 ) ,MAD、sm、Em、em 与血TT4、TSH水平的相关性最好 (P <0 0 0 1)。结论　先天性甲状腺功能低下症新生儿常伴有左心收缩和舒张功能下降 ,血甲状腺激素水平可直接影响左心功能 ,QTVI     

Maternal chronic hepatitis B virus does not affect neonatal biotinidase activity

BACKGROUND: Biotinidase activity is closely related to liver function. AIM: To evaluate whether maternal chronic hepatitis B virus (HBV) infection affects neonatal biotinidase activity. PATIENTS AND METHODS: Twenty-three asymptomatic pregnant women with HBV (group A) and 28 healthy pregnant women (controls) in the delivery room and their newborns (cord blood) underwent laboratory examinations. Serological HBV and liver function tests were performed with standard techniques, while biotinidase activity was measured with an HPLC method. RESULTS: Serological HBV tests and HBV DNA showed chronic HBV (precore mutant G1896A) in group A, whereas anti-HBc and anti-HBe were detected in their neonates. Liver function chemistry was found normal in controls and both groups of newborns. Moderately increased transaminases were found in the infected mothers. Interestingly, albumin levels did not differ among the studied groups. Biotinidase activity in HBV mothers (5.76+/-0.6 nmol/min/mL) was significantly decreased (p<0.001) as compared to controls (8.43+/-0.65 nmol/min/mL). The enzyme activity did not differ among the neonates. Biotinidase activity inversely correlated with transaminases but not with albumin or with HBV-DNA levels. CONCLUSIONS: Decreased biotinidase activities were evaluated in mothers with HBV and normal in their neonates. Biotin supplementation in the diseased mothers may prevent possible symptoms due to biotin recycling impairment.     

Cardiac troponin I levels and its relation to echocardiographic findings in infants of diabetic mothers

ABSTRACT: BACKGROUND: Cardiomyopathy is noted in up to 40% of infants of diabetic mothers, and the exact mechanisms responsible for it are unknown. The aim of this study was to compare between infants of diabetic mothers (IDM) and infants of non- diabetic mothers (INDM) as regards cardiac troponin I (cTnI) levels (as a marker of cardiac dysfunction) and to examine the relationship between this marker and neonatal echocardiographic changes (cardiac structure and function). METHODS: A prospective, comparative study included eighty full term neonates during the first three days of life, during the period from April 2008 to June 2011. They were divided into 2 groups, group I: included 40 infants of diabetic mothers (IDMs)and group II: included 40 infants of non diabetic healthy mothers as a control group. RESULTS: 37.5% of the IDMs were large for gestational age and demonstrated a significantly lower blood glucose level than the control group (34.6 +/- 11.3mg/dl Vs 77.2 +/- 19.8 mg/dl respectively) , respiratory distress and cyanosis were the presenting signs in 67.5% of IDMs. Cardiac TnI on the second day of life increased significantly in infants of diabetic mothers in comparison to INDM (p < 0.006) . IDMs had a significant increase in left atrial thickness ( 11.5 +/- 1.8mm in IDM Vs 10.5 +/- 0.9mm in INDM P < 0.002*) and a significant increase in septal thickness (5.0 +/- 1.2mm in IDM Vs 4.0 +/- 0.5mm in INDM P < 0.001*). CTnI correlated positively with interventricular septum thickness (P-value = 0.002*). Cardiac TnI was significantly increased in IDMs with respiratory distress (P -value < 0.05). CONCLUSIONS: This study demonstrated a highly significant positive correlation between cTnI level on the second day of life and the left ventricular end diastolic diameter (LVED) and interventricular septum diameter (IVSD). Cardiac troponin I (cTnI) is a useful biochemical marker for monitoring myocardial injury in infants of diabetic mothers. An elevated cTnI concentration in infants of diabetic mothers with respiratory distress was a good predictor for hypertrophic cardiomyopathy and/or left ventricular dysfunction.     

25-Hydroxyvitamin D and total calcium: extraordinarily low plasma concentrations in Saudi mothers and their neonates

Venous blood was obtained from 100 consecutive and unselected Saudi Arabian mothers and their neonates within 48 h after delivery. Plasma levels of 25-hydroxyvitamin D (25-OHD) and total calcium were measured in paired samples. Fifty-nine mothers and 70 neonates had subnormal (less than 10 ng/ml) 25-OHD levels. Plasma Ca concentrations were low in 61% of the mothers and 59% of the newborns consisting of 10 preterm and 38 full term babies. There were significant correlation between the plasma levels of maternal and neonatal 25-OHD (r = 0.54; P = 0.0001), maternal 25-OHD and Ca (r = -0.22; P = 0.03), neonatal 25-OHD and Ca (r = -0.28; P = 0.0009), and maternal and neonatal calcium levels (r = 0.46; P = 0.0001). Nevertheless, maternal 25-OHD was not invariably higher than that in the infant. Normocalcemia was observed in 29 neonates and 26 mothers (20 mother/baby pairs) in the presence of subnormal maternal 25-OHD. Twenty babies and 16 mothers including nine mother/baby pairs had hypocalcemia in the presence of normal levels of 25-OHD. This indicates that vitamin D plays a crucial, but not exclusive, role in calcium homeostasis during pregnancy. This study revealed that vitamin D deficiency is very prevalent during pregnancy in Saudi Arabia. It also showed that asymptomatic hypocalcemia in full term babies is far commoner than is generally appreciated. It is considered that vitamin D deficiency is primarily due to lack of exposure to sunlight. Encouragement to obtain sunlight exposure and fortification of food are the only alternative measures.     

Intrapartum magnesium sulfate exposure attenuates neutrophil function in preterm neonates

BACKGROUND: Prenatal exposure to magnesium sulfate, a drug that is frequently used for attempted tocolysis in preterm labor, could alter neutrophil functional activity in infants born preterm. OBJECTIVES: To determine the association between maternal tocolysis with magnesium sulfate and the cord blood neutrophil functional activity of preterm neonates. METHODS: The chemotaxis, random motility, and chemiluminescence of neutrophils were compared in the cord blood of 10 preterm neonates born to mothers tocolysed with magnesium sulfate, 10 preterm infants whose mothers had not received any tocolysis, and 10 term infants. Data regarding the maternal and neonatal magnesium and calcium levels were collected and analyzed in association with the cord blood neutrophil functional activity of the preterm infants. RESULTS: Neutrophil functional activity in the cord blood of the preterm neonates was significantly lower than in term neonates. However, the alteration of neutrophil chemotaxis, random motility and chemiluminescence was more noticeable in neonates with intrapartum exposure to magnesium sulfate as compared to preterm infants whose mothers received no tocolysis (30.9 +/- 2.3 vs. 36.7 +/- 2.7 microm, p < 0.01; 26.6 +/- 1.9 vs. 33.1 +/- 3.1 microm, p < 0.01; and 74.3 +/- 6.5 vs. 89.9 +/- 6.25 x 10(3) counts per min (cpm), p < 0.01, respectively). Furthermore, the reduction in neutrophil functional activity of preterm infants with intrapartum exposure to magnesium was directly correlated with the maternal serum magnesium levels (r = -0.90 to -0.85, p < 0.01). CONCLUSION: In infants born preterm, intrapartum exposure to magnesium sulfate is a risk factor contributing to the alteration in neutrophil motility and post-phagocytic bactericidal capacity.