| Objective: In order to analyze the cell mediated immune response of neonatal hyperbilirubinemia, evaluate the influence of phototherapy, and assess the clinic value of the assistance by immunology, we chose the neonatal hyperbilirubinemia as our object, and compared the immune adherence function of the red blood cell and the function of T cell subset after phototherapy.Methods: CD35 which reflects the immune adherence function of red blood cell, CD3+, CD4+, CD8+ and CD4+/CD8+ which reflect the function of T cell subset were measured in 60 neonates with hyperbilirubinemia (the group of hyperbilirubinemia), in which 33 were male, and 27 were female, 1~23 days of age, 38~42 weeks of fetal age, 2500~4000g, without asphyxia and infection, without the hereditary disease, metabolic disease, and immunological disease. In order to analyze the influence of different concentration of serum bilirubin on the immune function, we divided them into 3 groups: A, B and C; in order to explore the influence of phototherapy on immune function, the group of hyperbilirubinemia were divided into 2 groupsrandomly: the hyperbilirubinemia 1 (30 cases, phototherapy within 24 hours) and the hyperbilirubinemia 2 (30 cases, without phototherapy within 24 hours). The control group were 30 heathy neonates, which sex- and age-matched with the group of hyperbilirubinemia. The blood sample was obtained just into hospital, after 24 hours in hospital and recovery stage in the group of hyperbilirubinemia, and was collected only once in control group.CD35, CD3+, CD4+,CD8+ were determined by flow cytometry analysis apparatus, the serum bilirubin were determined by automatic biochemical analysis apparatus. The data were dealt with SPSS10.0, and were described in (xˉ ±s). Results:1 The changes of the function of CD35 and T cell subset during the acute and recovery stage of neonatal hyperbilirubinemia:1.1 CD35 during acute stage was lower than recovery stage distinctly (12.09±2.07/17.81±1.49), but they were all lower than the controls (19.47±3.94). There were marked different between the acute stage and recovery stage, the acute stage and the controls (P<0.01), and the recovery stage and the controls (P<0.05).1.2 CD3+, CD4+, CD4+/CD8+ during the acute stage were lower than the controls (58.29±4.15/65.20±6.71,40.77±2.53/45.90±5.75,2.43±0.11/2.69±0.64), the difference was distinctly (P<0.01, P<0.01, P<0.05); althoughCD8+ was lower than the controls, the difference was not marked (P>0.05); CD3+, CD4+, CD8+, CD4+/CD8+ were all increased during recovery stage (65.22±4.18,46.17±3.14,17.76±1.92,2.63±0.38), different from the acute stage distinctly (P<0.01), but had no marked difference from the controls (P>0.05).2 The influence of difference concentration serum bilirubin on immune function:2.1 With the increase of serum bilirubin concentration, CD35 decreased in turn (13.34±2.05/11.25±1.00/9.73±0.52), the difference among each groups was distinct (P<0.01).2.2 With the increase of serum bilirubin concentration, CD3+, CD4+, CD8+ also decreased in turn (60.55±3.63/57.45±2.53/52.13±2.09, 42.16±1.89/40.45±1.28/36.43±2.02, 17.41±1.03/16.63±0.79/15.01±0.50), the decrease among each groups was distinct (P<0.01), but the difference of CD4+/CD8+ were not marked (2.43±0.11/2.44±0.11/2.43±0.13, P>0.05).3 The changes of the serum bilirubin concentration , CD35 and T cell subset between the hyperbilirubinemia 1 and hyperbilirubinemia 2:3.1 Before phototherapy, the serum bilirubin concentration, CD35, CD3+, CD4+, CD8+, and CD4+/CD8+ between two groups were not much different (311.45±80.71/343.01±120.03,12.33±2.15/11.85±1.98,58.44±3.70/58.14±4.62,40.90±2.13/40.64±2.91,16.94±1.23/16.67±1.14,2.42±0.13/2.44±0.08; P>0.05). 3.2 After 24 hours phototherapy, CD35, CD3+, CD4+, CD8+ of hyperbilirubinemia 1 decreased distinctly (11.52±1.86/12.33±2.15,57.09±3.58/58.44±3.70,38.93±2.27/40.90±2.13,16.33±1.34/16.94±1.23), the difference was marked (P<0.01), while CD...
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