| ObjectiveTo investigate the relationship between the distribution of peripheral blood lymphocyte subsets and the gestational age,delivery mode and risk factors of premature delivery,and the relationship between peripheral blood lymphocyte subsets and periventricular leukinomalacia in premature infants.Methods129 neonates with gestational age ranging from 28 to 42 weeks who were born in our hospital from March 1,2018 to October 1,2019 and transferred to neonatal treatment were selected as the study objects.Inclusion criteria:(1)28≤gestational age(GA)<42 weeks;(2)Within 24h of birth;(3)Obtain informed consent of family members.Exclusion criteria:(1)With congenital developmental abnormalities,polycythemia,genetic and metabolic diseases,thrombocytopenia,history of asphyxiation;(2)Maternal autoimmune diseases and related diseases that may affect the immune system of the newborn.18 premature infants with periventricular leukomalacia during the 4-6 weeks after admission to the NICU in our hospital on March 1,2018 to October 1,2019 were selected,and 31 premature infants with similar gender,gestational age,day age and birth weight in the same period of admission were included as controls according to the ratio of 1:1 or 1:2.Inclusion criteria:(1)periventricular leukomalacia group:Both Ultrasound and MRI clearly showed encephalomalacia foci;(2)Healthy control group:Gender,gestational age,daily age,birth weight and treatment measures were not significantly different from those of the encephalomalacia group.(3)Informed consent of the family.Exclusion criteria:(1)With immune-related diseases after birth.(2)Exposure to drugs affecting immune function before and after birth.According to their gestational age,129 neonates were divided into early preterm group(28-32 weeks,n=99),middle and late preterm group(32-36 weeks,n=15)and full-term group(≥37 weeks,n=15).According to the causes of preterm delivery,114 premature infants were divided into the group of premature rupture of membranes(n=40),the group of iatrogenic premature delivery(n=51)and the group of spontaneous premature delivery(n=23).According to the mode of delivery,114 premature infants were divided into cesarean section group(n=83)and vaginal delivery group(n=31).According to the presence or absence of early infection,99 premature infants were divided into the early infection group(n=47)and the normal group(n=52).According to the presence of encephalomalacia during the imaging examination 4-6 weeks after birth,the patients were divided into encephalomalacia group(n=18)and control group(n=31).Newborns meeting the criteria of the study subjects were born 24 hours after birth or 4-6 weeks after birth was extracted 1ml of venous blood,placed at room temperature,and the levels of CD3+,CD4+,CD8+,γδ-T,and total lymphocyte subsets were detected by flow cytometry using the immunofluorescence monoclonal antibody kit within 8 hours.Result1.The percentage of γδ-T cells in middle and late preterm infants and full-term infants was significantly higher than that in early preterm infants,with statistically significant difference(P<0.05);The percentage of γδ-T cells in fullterm infants was higher than that in middle and late preterm infants,but the difference was not statistically significant(P>0.05);There was no significant difference in CD3+,CD4+,CD8+,total lymphocyte percentage and CD4+/CD8+ratio between different gestational age groups(P>0.05).2.The percentage of CD3+and CD4+cells in the peripheral blood of the cesarean section group was significantly higher than that of the vaginal delivery group,with statistically significant differences(P<0.05);The percentage of CD8+,γδ-T,total lymphocytes and CD4+/CD8+in cesarean section group were higher than those in vaginal delivery group,but there was no significant difference(P>O.05).3.There was no significant difference in the proportion of CD3+,CD4+,CD8+,γδ-T and total lymphocytes in the peripheral blood of neonatals among the groups with different preterm factors(P>0.05).4.There was no significant difference in the proportion of peripheral blood CD3+,CD4+,CD8+,γδ-T and total lymphocytes between the early-onset infection group and the non-early-onset infection group(P>0.05).5.The proportion of CD3+,CD4+,CD8+,γδ-T and total lymphocytes in peripheral blood in 1～2 months after birth was significantly higher than that whin 24 hours after birth,with statistically significant difference(P<0.05).6.The proportion of CD8+,γδ-T and total lymphocytes in the premature infants in the encephalomalacia group was significantly lower than that in the control group,with statistically significant differences(P<0.05).There was no statistically significant difference in CD3+,CD4+,CD4+/CD8+ratio between the encephalomalacia group and the healthy control group(P>0.05).Conclusion1.The proportion of neonatal peripheral blood γδ-T cells is related to gestational age,and with the increase of gestational age,the proportion of γδ-T cells increases.2.Peripheral blood lymphocyte subsets were not associated with the perinatal risk factors leading to preterm delivery.The mode of delivery has an effect on Peripheral blood lymphocyte subsets of newborn.3.The occurrence of periventricular leukinomalacia is related to immune dysfunction,and peripheral blood CD8+ and γδ-T cells may be used as predictors of cerebral maladjustment. |
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