新生儿感染性肺炎血清维生素D及免疫功能检测的临床研究

发布时间：2018-03-25 11:53

本文选题：维生素D　切入点：新生儿　出处：《昆明医科大学》2016年硕士论文

【摘要】：[目的]通过对感染性肺炎新生儿的血清维生素D水平、外周血T淋巴细胞亚群及免疫球蛋白的检测并与对照组进行比较分析,探讨新生儿肺部感染后体内维生素D和免疫功能变化的意义。[方法]收集2015年1月-2016年2月在昆明医科大学第二附属医院新生儿科住院的新生儿感染性肺炎47例,排除有新生儿出生时疾病史者,孕母妊娠期糖尿病的患儿3例,选取符合入选标准的44例新生儿感染性肺炎作为肺炎组。将同期住院的41例无明显感染的轻度黄疸新生儿作为对照组。两组新生儿于入院当天抽血检测维生素D水平、T细胞亚群、免疫球蛋白,常规查CRP.PCT.血常规、血培养等。[结果]1.肺炎组和对照组的一般资料比较：两组新生儿的性别、胎龄、出生体重、入院时体重、出生方式、喂养方式等可能影响血清维生素D及免疫功能的一般资料比较,差异均无统计学意义。两组资料同质,具有可比性。2.两组新生儿血清维生素D水平：肺炎组维生素D平均水平为(16.42±5.95)ng/mL,对照组维生素D平均水平为(15.73±5.62)ng/mL,两组维生素D平均水平对比差异无统计学意义(P0.05),两组新生儿的血清维生素D均低于20 ng/mL.3.两组新生儿免疫功能水平：肺炎组、对照组CD3+平均水平分别为(76.15±9.12)、(82.22±5.23),两组CD3+平均水平比较差异有统计学意义(P0.05)；肺炎组、对照组CD3+ CD4平均水平分别为(53.24±10.53)、(60.44±6.57),两组CD3+ CD4平均水平比较差异有统计学意义(P0.05)；肺炎组、对照组IgM平均水平分别为0.22(0.12-0.29)、0.15(0.12-0.18),两组IgM平均水平比较差异有统计学意义(P0.05)；两组CD3+CD8+、CD4+/CD8+、IgG比较无统计学意义(P0.05)。4.维生素D与免疫功能的相关分析：n=85例维生素D水平与免疫功能相关性分析提示维生素D水平与CD3+呈低度正相关(r=0.44 P=0.001)。5.经二分类Logistic回归分析结果提示CD3+、CD3+ CD4+的降低是肺炎的危险因素,维生素D是肺炎保护因素。[结论]1.感染性肺炎组及对照组新生儿的血清维生素D水平普遍偏低,均低于于20 ng/mL,两组血清维生素D水平比较无差别。2.感染性肺炎新生儿的细胞免疫功能受到不同程度抑制,以CD3+及CD3+ CD4+的降低为主。3.IgM在感染性肺炎新生儿体液免疫中可能发挥重要作用。
[Abstract]:[Objective] to neonatal pneumonia serum vitamin D levels, detection of peripheral blood T lymphocyte subsets and immunoglobulin and compared with control group, to explore the significance of changes in vitamin D]. Methods and immune function in neonatal pulmonary infection after January 2015 -2016 year in February in the Second Affiliated Hospital of Kunming Medical University pediatric hospital neonatal pneumonia in 47 cases, excluding neonatal diseases, 3 cases of pregnant women with gestational diabetes were selected according to the inclusion criteria of 44 cases of neonatal pneumonia as pneumonia group. 41 infants with no obvious infection mild neonatal jaundice as control group. Two groups of neonates on the day of admission blood levels of vitamin D, T cell subsets, immunoglobulin, CRP.PCT. blood routine examination, blood culture. The]1. pneumonia group and control group Comparison of general information: the two groups in gender, gestational age, birth weight, birth weight on admission, and general data of feeding may affect the immune function and serum vitamin D, the difference was not statistically significant. Two sets of data are homogeneous, comparable to.2. in the two groups of neonatal serum vitamin D levels. The pneumonia group average vitamin D level was (16.42 + 5.95) ng/mL, the control group for the average vitamin D level (15.73 + 5.62) ng/mL, there was no significant difference between the two groups in average vitamin D level (P0.05), comparing the two groups of neonatal serum vitamin D was less than 20 ng/mL.3. in the two groups of neonatal immune function: the pneumonia group the control group, the average level of CD3+ were (76.15 + 9.12), (82.22 + 5.23), the two groups was statistically significant difference between the average level of CD3+ (P0.05); pneumonia group, control group CD3+ CD4 levels were (53.24 + 10.53), (60.44 + 6.57), the two groups had statistical significance CD3+ CD4 average difference (P0.05); pneumonia group, control group IgM average levels were 0.22 (0.12-0.29), 0.15 (0.12-0.18), the two groups was statistically significant difference between the average level of IgM (P0.05); the two group of CD3+CD8+, CD4+/CD8+, IgG was not statistically significant (P0.05).4. correlation analysis of vitamin D and immune function in n=85 patients: correlation analysis between vitamin D levels and immune function that vitamin D levels are positively related with CD3+ (r=0.44 P=0.001.5.) by two Logistic regression analysis results suggested that CD3+, CD4+ reduced CD3+ is a risk factor for pneumonia, pneumonia is the protection of vitamin D factors. Conclusion]1. infection pneumonia group and control group of neonatal serum vitamin D levels are generally low, were lower than in 20 ng/mL, two groups of serum vitamin D level was no difference.2. infected pneumonia of newborn cells free The function of pestilence is inhibited in varying degrees, and the decrease of CD3+ and CD3+ CD4+ may play an important role in the humoral immunity of newborns with infectious pneumonia.

【学位授予单位】：昆明医科大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R722.135

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