免疫和细胞因子在新生儿胆管闭锁新生儿肝炎综合症早期诊断价值研究.docVIP

免疫和细胞因子在新生儿胆管闭锁新生儿肝炎综合症早期诊断价值研究 　　[摘要]目的：本课题通过探讨新生儿胆道闭锁、新生儿肝炎综合征在免疫和细胞因子的差异性，以寻找新的早期诊断有鉴别意义的实验室指标，为疾病的诊断、治疗提供理论基础。方法：对2006年～2010年我院明确诊断为新生儿胆道闭锁、新生儿肝炎综合征患儿各40例，1～3月龄，观察两组治疗前机体的免疫和炎症方面的状况。结果：BA组和NHS组CD4、CD8及CD4／CD8比值均较正常组下降，CD4，CD4／CD8与正常组有统计学差异（P0.05），且两者之间CD4／CD8有统计学差异（P0.05）；BA组IFN-γ、Th1／Th2比值较NHS组、正常组明显降低，有统计学差异（P0.05）。结论：新生儿肝炎和胆管闭锁的早期鉴别诊断一直是困扰临床医师的难题，T细胞免疫反应在新生儿胆道闭锁及新生儿肝炎综合征中扮演了重要角色，两者在免疫学和细胞因子方面的差异，特别是CD4／CD8比值降低，Th1／Th2比值升高很有可能成为临床快速、特异、简单、实用的鉴别诊断方法。 　　[关键词]免疫和细胞因子；新生儿胆道闭锁；新生儿肝炎综合征；早期诊断价值 　　[Abstract]Objective Discussion of this issue through the neonatal biliary atresia， neonatal hepatitis syndrome and cytokines in the immune differences， to find new meaning in early differential diagnosis of laboratory indicators of disease diagnosis and treatment of theoretical basis. Method 2006 to 2010 newborns in our hospital diagnosed as biliary atresia， neonatal hepatitis syndrome 40 cases， 1 to 3 months of age， were observed before treatment， the immune and inflammatory aspects of the situation. Results BA group and the NHS group of CD4， CD8 and CD4/CD8 ratio decreased compared with the normal group， CD4， CD4/CD8 and the normal group were significantly different （P0.05）， and CD4/CD8 were significantly different between the two （P0.05）； BA group IFN-γ， Th1/Th2 ratio than the NHS group and normal group was significantly lower， with statistical difference （P0.05）. Conclusion Neonatal hepatitis and biliary atresia in the early differential diagnosis has been a problem plagued clinicians， T cell immune response in the neonatal biliary atresia and neonatal hepatitis syndrome plays an important role， both in immunology and cell factors to differences ， in particular， CD4/CD8 ratio decreased， Th1/Th2 ratio increased likely to be the clinical rapid， specific， simple， practical method of differential diagnosis. 　　[Key words]Immunity and cell factor； neonatal biliary atresia； neonatal hepatitis syndrome； early diagnosis 　　 　　1材料与方法 　　1、材料：将年龄三个月的确诊为婴儿肝炎综合征患儿的临床资料、腹腔镜探查确诊为