新生儿中性粒细胞粘附分子CD11b表达的定量研究

目的探讨新生儿中性粒细胞粘附分子CD11b表达水平及其在发育过程中的变化。方法将60例正常足月新生儿分为3组 :自然分娩脐血25例 (VD)、择期剖宫产脐血20例 (ECS)和外周静脉血15例 (nPV)。采用全血流式细胞术检测中性粒细胞CD11b平均荧光强度 (MFI)和阳性细胞百分比 (CD11b % )。10例健康成人外周静脉血作为对照 (aPV)。结果VD、ECS、nPV和aPV4组的中性粒细胞CD11b %分别为0.95±0.07、0.96±0.03、0.93±0.04和0.96±0.02 ,4组间比较差异无显著性 (F=1.44,P>0.05)。4组的CD11bMFI分别为701.4±601.6、556.6±273.9、1090.4±338.1和447.7±249.9,4组间比较差异有显著性 (H=19.03,P<0.001) ,其中 ,nPV高于VD、ECS和aPV(P均<0.05) ,后3组组间两两比较差异均无显著性 (P均>0.05)。结论静息状态下足月新生儿中性粒细胞粘附分子CD11b膜表达正常或增高 ;分娩方式不影响足月儿中性粒细胞CD11b膜表达。     

中性粒细胞粘附分子CD11b表达对新生儿败血症早期诊断价值的研究

目的　观察新生儿败血症中性粒细胞粘附分子CD11b表达的规律 ,并评价其在新生儿败血症早期诊断中的价值。方法　将 5 1例临床疑似败血症的新生儿根据其临床表现及WBC、PLT、血浆CRP和未成熟中性粒细胞数与中性粒细胞总数比值 (I/T)四项指标 ,分为败血症和可疑败血症两组。采用全血流式细胞术检测患儿和 15例正常对照组新生儿中性粒细胞CD11b的平均荧光强度 (MFI)。结果　败血症组 2 3例 ,可疑败血症组 2 8例。两组中性粒细胞CD11b分别为 (32 0± 189)、(4 5 6± 2 13)MFI,均显著低于正常对照组的 (10 90± 338)MFI(t分别为 - 9 0 1、- 7 5 6 ,P均 <0 0 0 1) ,败血症组又低于可疑败血症组 ,差异有显著性 (t=- 2 39,P <0 0 5 )。高CRP组患儿CD11b为 (2 11± 16 4 )MFI,低于低CRP组的 (5 0 5± 2 6 5 )MFI,差异有显著性 (t=2 6 4 ,P <0 0 5 )。中性粒细胞CD11b≤ 6 0 0MFI对疑似败血症新生儿诊断的敏感性、特异性、阳性和阴性预测值分别为 86 3%、10 0 %、10 0 %、6 8 2 % ,CD11b检测阳性率为 86 3% ,高于血培养的阳性率 (17 6 % ) ,差异有显著性 (χ2 m=31 2 ,P <0 0 5 )。结论　新生儿败血症中性粒细胞粘附分子CD11b表达下调 ,其下调与感染严重程度有一定关系。中性粒细胞CD11b的动态检测对早期     

肺炎患儿外周血白细胞表面粘附分子CD11b、CD54、CD62L表达的研究

目的 探讨肺炎患儿外周血白细胞表面CD11b、CD54、CD62L在发病中的作用及其与病情的关系。方法 采用全血直接免疫荧光流式细胞术检测34例肺料患儿及22例正常小儿外周血白细胞粘附分子（AMS）CD11b、CD54、CD62L的表达。结果 1．肺炎组与对照组比较：淋巴细胞（L）、单核细胞（M）、多形核细胞（PMN）表面CD11b、CD54、CD62L的阳性细胞百分率（PPC）和（或）平均荧光强度（MFI）普遍上调（P＜0．05或＜0．0001），其中以M的AMS牙调最为显著；2．重型肺料组与轻型组比较；PGE表面CD11b、L表面CD62L的PPC和（或）MFI表达上调，3类白细胞表面CD54的PPC和MFI表达均显著上调（P＜0．05或P＜0．001）。结论 1．AMS在肺炎的发病中发挥了重要作用；在三类白细胞表面CD54表达均同时上调的水平有可能作为判断肺炎病情程度的免疫学指标；3．此结果可能为肺炎的抗粘附疗法提供了一些依据。     

������ϸ��CD����64����CD����11b������ڪ���������Ѫ֢����еļ�ֵ

目的 探讨中性粒细胞CD11b、CD64在新生儿败血症诊断中的价值.方法 2005年1月至2005年12月检测河北医科大学第一医院儿科36例败血症新生儿及26名健康新生儿中性粒细胞CD64、CD11b的表达水平和CRP质量浓度,比较各指标对诊断新生儿败血症的灵敏度、特异度、阳性预测值、阴性预测值和约登指数,评价它们对诊断该病的价值.结果 (1)败血症组CD64、CD11b水平均明显高于对照组(P＜0.01);(2)以CD64≥35MFI,CD11b≥1300MFI,CRP≥8mg/L为阳性标准,三指标对诊断败血症的灵敏度分别为95.7%、82.6%、69.6%,CD64的特异度95.8%、阳性预测值95.6%、阴性预测值95.4%、约登指数91.5%;(3)CD11b、CD64水平在治疗前后差异有显著意义,P均＜0.01.结论 中性粒细胞CD11b、CD64可作为新生儿败血症早期诊断、判断病情的可靠指标.     

足月新生儿脐血清粒细胞集落刺激因子水平的研究

本文应用抗粒细胞集落刺激因子（G─CSF）的单克隆抗体、采用间接免疫吸附法对148例足月新生儿脐血清中G─CSF水平进行了测定，并与41例正常小儿及50例成人血清相比较，同时观察了G─CSF水平与其性别、出生体重、白细胞总数、中性粒细胞绝对计数的关系。结果显示11例（7．4％）脐血清G─CSF水平低于0．5ng／ml，137例（89％）G─CSF均高于0．5ng／ml，其平均值为3．4ng士0.05ng／ml，而且G─CSF水平与其性别、出生体重、白细胞总数及中性粒细胞绝对计数无明显相关（P均＞0.5）；结果还显示1～5个月小儿（41例）及成人血清（50例）G─CSF水平皆低于0．5ng／ml，提示足月新生儿脐血清G─CSF水平大大高于正常小儿及成人水平，本文首次报道中国足月新生儿脐血清G─CSF正常值，为研究新生儿免疫功能及为脐血的合理应用提供了依据。     

败血症新生儿血中性粒细胞CD64表达的意义

目的 探讨中性粒细胞CD64对新生儿败血症早期诊断、病情判断、预后分析的价值.方法 败血症组36例在入院初及恢复期采空腹静脉血,应用流式细胞术测定中性粒细胞CD64,同时行外周血CRP测定;非感染组22例和健康对照组26例一次性采血,采用同样方法测定其血CD64和CRP.结果 败血症组CD64水平为(60.37±22.70)MFI,显著高于非感染组[(27.91±4.91)MFI]和对照组[(23.14±5.10)MFI](Pa＜0.01),恢复期水平下降.以CD64≥35 MFI为阳性标准,中性粒细胞CD64对新生儿败血症诊断的敏感度95.7%、特异度95.8%,均优于CRP.结论 中性粒细胞CD64可作为新生儿败血症早期诊断、病情判断的可靠指标.     

人脐血T、B淋巴细胞和NK细胞的免疫学表达特性

目的 探讨人脐血T、B淋巴细胞和NK细胞，以及T／NK细胞杀伤性抑制性受体（KIR）表达的免疫学特性及其意义。方法 应用流式细胞仪检测26例正常新生儿脐血的T、B淋巴细胞和NK细胞抗原标记，包括CD45RA、CD45RO、CD69、CD25、CD40L、CD40、CD10、CD20和CD16等抗原的表达，以及脐血T／NK细胞上KIR分子（CD158a和CD158b抗原）的表达，并与正常儿童外周血比较。结果 脐血T淋巴细胞中CD45RA^ 细胞表达高于外周血（P＜0．01），CD45RO^ 则明显低于外周血（P＜0．01）；脐血T细胞CD69表达极低；CD25在CD8^ 细胞亚群中几乎不表达；CD40L在脐血T细胞中表达低于外周血（P＜0．05）。脐血B淋巴细胞中不成熟亚群CD10^ ／CD19^ 比例增高，成熟B细胞表型CD19、CD20、CD40等抗原均明显高于正常外周血（P＜0．01）。脐血中T淋巴细胞和NK细胞均存在KIR分子表达；脐血和外周血中T淋巴细胞CD158分子表达低于NK细胞（P＜0．01），脐血T淋巴细胞亚群中CD158分子表达低于正常外周血；CD158几乎不表达于CD4^ T细胞，主要表达于CD8^ T细胞，且以CD158a^ 为主；脐血中NK细胞CD158分子表达高于T淋巴细胞（P＜0．05），但明显低于外周血NK细胞KIR的表达（P＜0．01）。结论 脐血T淋巴细胞包括原始和早期T细胞以及T细胞受体表达障碍，导致脐血T淋巴细胞免疫功能不成熟，可能是脐血移植（UCBT）后移植物抗宿主病（GVHD）发生率低和程度轻的重要原因之一。脐血B淋巴细胞免疫应答障碍可能缘于T淋巴细胞表型或功能的障碍。脐血T／NK细胞KIR的表达特性提示，KIR可能与UCBT中GVHD和移植物抗白血病（GVL）效应有关。     

全身炎症反应综合征患儿中性粒细胞淋巴细胞CD11b表达意义

目的：探讨全身炎症反应综合征（SIRS）患儿血液中性粒细胞、淋巴细胞CD11b表达对诊断和判断病情的意义。方法：用流式细胞术检测36例SIRS患儿血液中性粒细胞、淋巴细胞CD11b表达水平,28例一般感染性疾病,不符合SIRS诊断标准的患儿作为对照组。比较各指标对诊断SIRS的灵敏度、特异度,评价它们对诊断SIRS和判断病情的价值。结果：急性期SIRS组中性粒细胞CD11b表达为（96.7±8.1）%,高于对照组的（85.1±5.1）%,差异有显著性（P＜0.05）。中性粒细胞CD11b＞92.24%为阳性标准,诊断SIRS敏感性和特异性分别为97.2%,92.9%。急性期SIRS组淋巴细胞CD11b表达为(13.4±8.6)%,对照组为（19.2±6.4）%,差异有显著性（P＜0.05）;其中严重脓毒症组淋巴细胞CD11b表达为（7.3±3.0）%,低于非感染SIRS组的（19.3±2.9）%和脓毒症组的(15.9±12.5)%（P＜0.01）。恢复期SIRS组淋巴细胞CD11b表达为（13.35±4.89）%,对照组为（13.8±4.7）%,差异无显著性（P＞0.05）。结论：中性粒细胞CD11b可作为诊断SIRS的可靠指标,淋巴细胞CD11b表达下调可能是SIRS患儿病情加重的信号。［中国当代儿科杂志,2009,11（7）：540-542］     

重症肺炎患儿中性粒细胞和淋巴细胞CD11b表达的意义

目的 探讨重症肺炎患儿中性粒细胞、淋巴细胞CD11b表达的意义.方法 用流式细胞术检测36例重症肺炎患儿(重症肺炎组)血液中性粒细胞、淋巴细胞CD11b表达,并与35例普通肺炎患儿(普通肺炎组)和30例正常儿童(正常对照组)比较.结果 急性期重症肺炎组和普通肺炎组中性粒细胞CD11b[ (90.67±7.03)％,(84.03±5.08)％]表达均高于正常对照组[(69.32±5.72)％](P＜0.05),且急性期重症肺炎组中性粒细胞CD11b表达高于普通肺炎组(P＜0.05).恢复期重症肺炎组中性粒细胞CD11b[ (72.68 ±2.07)％]和普通肺炎组CD11b[ (71.45 ±3.21)％]表达均低于同组急性期CD11b的表达(P＜0.05).急性期重症肺炎组淋巴细胞CD11b表达[(13.35 ±6.52)％]低于普通肺炎组[(19.19±6.47)％](P＜0.05),与正常对照组[(12.42±6.43)％]比较差异无统计学意义(P＞0.05);恢复期,重症肺炎组淋巴细胞CD11b表达[(13.37 ±4.88)％]与普通肺炎组[(13.78±4.53)％]比较差异无统计学意义(P＞0.05).结论 中性粒细胞、淋巴细胞CD11b表达在重症肺炎的演变过程中起到一定的作用,可作为重症肺炎的判断依据,预测疾病的发展.     

中性粒细胞CD64在新生儿败血症诊断中的价值

目的探讨外周血中性粒细胞CD64表达水平在新生儿败血症早期诊断中的价值。方法败血症患儿36例,根据病史、临床表现、实验室检查确定诊断;另设对照组26例。应用流式细胞仪检测两组外周血中性粒细胞CD64表达水平。结果败血症组外周血中性粒细胞CD64表达为(60.37±22.70)[平均荧光强度(MFI)],显著高于对照组(23.14±5.10)MFI(P<0.001);败血症组恢复期CD64表达水平下降,但仍高于对照组。中性粒细胞CD64对新生儿败血症诊断的敏感性为95.7%,特异性95.8%,阳性预测值95.6%,阴性预测值为95.4%。结论外周血中性粒细胞CD64测定有助于早期诊断新生儿败血症,判断病情、评价疗效和估计预后。     

Comparison of L-selectin and CD11b on neutrophils of adults and neonates during the first month of life

The newborn infant is particularly susceptible to infection in the first weeks of life and this may be, in part, related to functional impairment of neonatal neutrophils in regard to adherence, chemotaxis, and migration. Differences in expression of the neutrophil adherence molecules, L-selectin and CD11b/CD18 (Mac-1), have been previously demonstrated in cord blood and in very young infants (相似文献   

Labor promotes neonatal neutrophil survival and lipopolysaccharide responsiveness

Labor is a mild proinflammatory state that is associated with fetal leukocytosis. Elective cesarean section has been linked with increased neonatal morbidity, which may be partially immune mediated. We hypothesized that labor may alter neutrophil phenotype and thereby decrease neonatal complications. We characterized neutrophil function and survival in normal neonates after either uncomplicated vaginal delivery (VD) or elective cesarean section (CS) without labor. Spontaneous neutrophil apoptosis is delayed in cord blood neutrophils of neonates after normal labor (VD) compared with CS, as assessed by propidium iodide DNA incorporation using flow cytometry. This demonstrates their ability to maintain an inflammatory response. CD11b expression on neonatal neutrophils after CS is decreased, providing further evidence of altered activation or priming. Lipopolysaccharide responsiveness, characterized by CD11b and apoptosis, is similar in VD and adults, but CS-derived neutrophils are unresponsive. Baseline TLR-4 levels are elevated in CS in contrast to the other groups, although expression is not up-regulated by lipopolysaccharide co-incubation. Neonatal neutrophil survival and function are altered by labor and may increase antibacterial function and neutrophilia. This suggests that labor of any duration may be immunologically beneficial to the normal term neonate.     

新生儿缺氧缺血性脑病中性粒细胞CD11b、CD18变化及临床意义

本文探讨CD11b、CD18在新生儿缺氧缺血性脑病中的意义。HIE新生儿30例,(轻度13例,中度10例,重度7例)及20例对照新生儿采用流式细胞术检测生后24～48 h、7 d CD11b、CD18(免疫荧光强度 MFI)值。HIE组 CD11b 24～48 h(2929.35±216.04)、7 d(1921.58±251.21)较对照组(1222.68±139.09)均明显升高(P相似文献   

Increased respiratory burst and increased expression of complement receptor-3 (CD11b/CD18) and of IL-8 receptor-A in neutrophil granulocytes from newborns after vaginal delivery

To study neutrophil activation in cord blood as a function of the mode of delivery, we performed analysis of the function of neutrophil granulocytes by assessing their ability to produce reactive oxygen products (ROP) as well as neutrophil cell surface expression of CD11b/CD18 and interleukin (IL)-8 receptors quantified with flow cytometry. Plasma levels of granulocyte colony-stimulating factor (G-CSF) were measured using an immunoassay. Neutrophil granulocytes were derived from cord blood of term newborns delivered vaginally (n = 20) and by cesarean section (n = 10), and, for comparison, from adult peripheral blood (n = 15). Blood neutrophil counts and the capacity of neutrophil granulocytes to produce ROP in response to stimulation with Escherichia coli was increased in newborns after vaginal delivery as compared to newborns delivered by cesarean section. The level of expression of the adhesion molecule/complement receptor CD11b/CD18 and the chemokine receptor IL-8 RA was also higher after vaginal delivery. Plasma concentrations of G-CSF in cord blood of newborns were higher than those of adults with no difference detectable between vaginal delivery and cesarean section. The data demonstrate a higher functional responsiveness and a higher expression level of functionally important receptors in neutrophils after vaginal delivery possibly due to activation of neutrophil granulocytes during labor.     

Administration of recombinant human granulocyte-colony stimulating factor to septic neonates induces neutrophilia and enhances the neutrophil respiratory burst and β2 integrin expression Results of a randomized controlled trial

The objective of this study was to investigate the effect of treatment with recombinant human granulocyte-colony stimulating factor (rhG-CSF) on the neutrophil count and function of preterm neonates with documented sepsis. For this purpose 62 preterm neonates with proven sepsis and 19 healthy preterm ones were studied. Of the 62 patients, 27 septic neonates had an absolute neutrophil count (ANC) >5000/mm³ (group A) and were scheduled not to receive rhG-CSF and 35/62 had an ANC <5000/mm³ (n= 35) and were randomly assigned either to receive rhG-CSF (group B) or not to receive it (group C). rhG-CSF (10 μg/kg) was administered for 3 consecutive days (0, 1, 2). The ANC, plasma levels of G-CSF (ELISA), neutrophil respiratory burst activity (NRBA) and neutrophil expression of CD11a, CD11b and CD11c (flow cytometry) were measured in all septic neonates on days 0 (onset of sepsis), 1, 3 and 5 and in the healthy neonates once within the first 2 days of life. We found that on day 0, G-CSF levels of all groups of septic neonates were significantly higher than those of the healthy ones. The highest levels were observed in group A. NRBA was diminished only in groups B and C and the expression of CD11a and CD11c was reduced in all groups of septic neonates. Administration of rhG-CSF resulted in a rapid and significant increase in ANC, NRBA and CD11a, CD11b and CD11c expression that persisted throughout the follow up. Conclusion The administration of granulocyte colony stimulating factor to septic neonates significantly increases the absolute granulocyte count and enhances the neutrophil respiratory burst and β₂ integrin expression. Received: 25 March 1997 and in revised form: 5 August 1997 / Accepted: 14 October 1997     

Neutrophil elastase level in cord blood and diagnosis of infection in mature and premature neonates

We determined the concentration of umbilical cord blood neutrophil elastase (EN) in 143 neonates. The infants were divided into four groups: A - Term non-infected, B - Term infected, C - Preterm non-infected, D - Preterm infected. In the study a low concentration of cord blood elastase in premature children was found. It was significantly lower in preterm non-infected (p<0.001) and infected (p<0.05) neonates than in non-infected term children. In full-term infected neonates mean concentration of elastase was markedly (p<0.001) higher as compared to term healthy ones. 87% values of cord blood elastase measured in full-term infected neonates and 6% in preterm ones exceed the upper limit reference interval (209.3 ug/L) while 97% measurements in preterm neonates (all with and without clinical signs of infection) were within the reference range. We conclude that significant differences in elastase level in the cord blood depend on age of gestation at delivery. These age-dependent differences of elastase concentration can be taken into consideration and examination of cord blood elastase concentration may provide a valuable indicator in early diagnosis of sepsis in neonates. In full-term neonates cord blood neutrophil elastase is a good marker of infection.     

Extracellular release of bactericidal/permeability-increasing protein in newborn infants

Upon activation, polymorphonuclear leucocytes (PMN) release bactericidal/permeability-increasing protein, (BPI) from their azurophil granules. BPI selectively binds to the lipopolysaccharide (LPS) on gram-negative bacteria and induces their death. This study examined plasma BPI concentration levels in healthy newborns and in newborns with clinical sepsis, and the ability of PMN from preterm and term infants to release BPI. We also studied the release of myeloperoxidase (MPO), and the surface expression of adhesion molecule CD11b on PMN. In infants with clinical sepsis, plasma BPI concentration was higher, 27.8 microg/L [8.6-883; median (range)] (n = 11), than in healthy term infants 8.9 microg/L (3.9-179) (n = 17), and in adults 7.3 microg/L (0.7 -18.4) (n = 15); p = 0.014, Kruskal-Wallis. In preterm infants (n = 8), the ability of PMN to release BPI in vitro after stimulation with PMA was 8.8, in term infants it was 15.9 (n = 29; p > 0.05 vs. preterm infants) and in adults 23.4 ng/10(6) PMN (n = 15; p = 0.024 and p > 0.05 vs. preterm and term infants, respectively). The corresponding values of MPO were 20.0 ng/10(6) (11.3-46.7) in preterms, 19.0 ng/10(6) (2.2-223.7) in terms, and 27.8 ng/10(6) (9.1-80.7) in adults; p = 0.67 between groups. In infants with clinical sepsis, CD11b level was higher, 292 RFU (234-403) than the basal CD11b expression levels in healthy newborn infants, 116 RFU (76-145); P = 0.0001. FMLP-stimulated PMN CD11b expressions in preterm cord blood, 1071 RFU (552-1286) and in term cord blood, 918 (567-1472) were on the same level, but lower than that in adult blood, 1592 (973-1946); p < 0.001, ANOVA. Our findings suggest that in preterm infants the ability to release BPI is lower than in adults and term infants. These findings suggest that premature neonates have an impaired ability to mobilize BPI, possibly contributing to their marked susceptibility to infections with Gram-negative bacteria.