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目的探讨光疗对新生儿高未结合胆红素血症免疫功能的影响及其机制。方法将100例高未结合胆红素血症足月新生儿随机分成5组:枯草杆菌二联活菌颗粒(妈咪爱)组(A组)、妈咪爱联合连续光疗组(B组)、妈咪爱联合间断光疗组(C组)、连续光疗组(D组)和间断光疗组(E组),5组均在治疗前0 h和治疗第24、48小时抽血分别测定血IL-2、IL-10及血清胆红素水平,分析5组治疗前后各免疫指标的变化。结果 B组、C组、D组、E组治疗第24、48小时IL-2、IL-10水平与治疗前0 h比较均增多,差异均有统计学意义(Pa<0.05);B组、C组、D组、E组治疗第48小时IL-2、IL-10水平与24 h比较也均有增多,差异均有统计学意义(Pa<0.05)。治疗后第24小时血IL-2、IL-10水平比较:B组比C组偏高,D组比E组偏高,差异均有统计学意义(Pa<0.001);治疗后第48小时IL-2比较:B组比C组偏低,D组比E组偏低,差异均有统计学意义(Pa<0.001);治疗后第48小时IL-10的比较:B组比C组偏高,D组比E组偏高,差异均有统计学意义(Pa<0.001)。结论光疗除可降低新生儿血清未结合胆红素水平外,还可使血IL-2、IL-10水平增加,进而影响新生儿的免疫功能,且显示在对高未结合胆红素血症新生儿细胞免疫功能的调节方面间断光疗优于连续光疗。
Objective To investigate the effect and mechanism of phototherapy on immune function in neonates with un-conjugated hyperbilirubinemia. Methods 100 neonates with full-term unconjugated bilirubin were randomly divided into five groups: group A (Bacillus subtilis), group A (group B) (C group), continuous phototherapy group (D group) and intermittent phototherapy group (E group). All the 5 groups were drawn blood before treatment and on the 24th and 48th hour after treatment, respectively. Blood IL -2, IL-10 and serum bilirubin, and the changes of each immune index before and after treatment were analyzed. Results The levels of IL-2 and IL-10 in group B, group C, group D and group E at 24 and 48 hours after treatment were all significantly higher than those at 0 hour before treatment (all P <0.05) The levels of IL-2 and IL-10 in group C, group D and group E also increased at 24 hours after treatment, with statistical significance (Pa <0.05). The levels of IL-2 and IL-10 in the 24th hour after treatment were higher in group B than those in group C, and higher in group D than in group E (P <0.001) -2: B group was lower than C group, D group was lower than E group, the difference was statistically significant (Pa <0.001); 48 hours after treatment IL-10 comparison: B group was higher than C group , D group was higher than E group, the difference was statistically significant (Pa <0.001). Conclusion In addition to light therapy can reduce neonatal serum unconjugated bilirubin levels, but also make blood IL-2, IL-10 levels increased, thereby affecting the immune function of newborns, and showed that in the high unbound bilirubin Intermittent phototherapy is better than continuous phototherapy in the regulation of neonatal cellular immunity.