淋巴细胞CD3~+、CD4~+、CD8~+亚群检测在早发型新生儿败血症诊断中的价值

目的探讨早发型新生儿败血症诊断中,淋巴细胞CD3~+、CD4~+、CD8~+百分比检测的价值。方法将2014年1月至2015年6月出生,7d内发病,疑似感染的患儿纳入本研究,入院24h内采集静脉血,检测CD3~+、CD4~+、CD8~+淋巴细胞百分比,C反应蛋白(CRP)及血常规,在抗菌药物使用前做血培养。将其中血培养证实为早发型新生儿败血症的足月新生儿作为败血症组,血培养阴性的作为局部感染组。同时选择同期因高胆红素血症(排除感染等因素所致)而住院的足月新生儿作为非感染组。采用流式细胞仪对上述患儿标本进行检测,观察并比较3组间淋巴细胞亚群CD3~+、CD4~+、CD8~+百分比。结果败血症组CD3~+[(40.3±10.6)%],CD4~+[(28.6±11.2)%],CD8~+[(10.8±2.6)%]低于局部感染组的CD3~+[(64.8±9.8)%],CD4~+[(48.9±10.2)%],CD8~+[(17.6±5.6)%]和非感染组的CD3~+[(62.6±11.6)%]、CD4~+[(46.4±13.6)%]、CD8~+[(16.5±7.3)%],差异有统计学意义(P0.05),局部感染组的CD3~+、CD4~+、CD8~+与非感染组之间比较,差异无统计学意义(P0.05)。结论CD3~+、CD4~+、CD8~+百分比可以作为诊断早发型新生儿败血症的指标。

Value of lymphocyte CD3+ ,CD4+ and CD8+ subsets detection in early diagnosis of neonatal septicemia

Objective To investigate the value of T-lymphocyte subsets CD3+ ,CD4+ and CD8+ percentage detection in the diag-nosis of early-onset neonatal sepsis .Methods The neonates born in January 2014 to June 2015 with suspected infection and onset within 7 d were included into this study .The venous blood was collected within 24 h after admission .CD3+ ,CD4+ ,CD8+ lympho-cyte percentage ,C reactive protein and blood routine were detected .The blood culture was performed before the use of antibacterial drugs .The full-term neonates with early onset sepsis confirmed by blood culture were taken as the sepsis group and those of nega-tive blood culture was taken as the local infection group select the blood culture negative for local infection group .At the same time , the hospitalized full-term neonates with hyperbilirubinemia (excluding cases caused by factors such as infection ) served as the con-trol group .The flow cytometery was adopted to detect the samples of above neonatal patients .The lymphocyte subsets CD3+ , CD4+ and CD8+ percentages were observed and compared among 3 groups .Results CD3+ [(40 .3 ± 10 .6)% ] ,CD4+ [(28 .6 ± 11 .2)% ] and CD8+ [(10 .8 ± 2 .6)% ] in the sepsis group were lower than CD3+ [(64 .8 ± 9 .8)% ] ,CD4+ [(48 .9 ± 10 .2)% ] , CD8+ [(17 .6 ± 5 .6)% ] in the local infection group and CD3+ [(62 .6 ± 11 .6)% ] ,CD4+ [(46 .4+13 .6)% ] and CD8+ [(16 .5 ± 7 .3)% ] in the non-infection group ,the differences were statistically significant (P<0 .05);CD3+ ,CD4+ and CD8+ had no statisti-cal difference between the local infection group and non-infection group(P>0 .05) .Conclusion CD3+ ,CD4+ ,CD8+ percentage can be used as an indicator for the diagnosis of early onset neonatal sepsis .