强光疗不影响高胆红素血症新生儿细胞免疫功能及出院后近期免疫反应

doi:10.16352/j.issn.1001-6325.2024.03.0379

基础医学与临床 ›› 2024, Vol. 44 ›› Issue (3): 379-383.doi: 10.16352/j.issn.1001-6325.2024.03.0379

强光疗不影响高胆红素血症新生儿细胞免疫功能及出院后近期免疫反应

刘珍¹, 王大连¹, 张婕², 张其星¹, 王斐^1*

复旦大学附属上海市第五人民医院 1.儿科;2.检验科,上海 200240

收稿日期:2023-10-25 修回日期:2024-01-04 出版日期:2024-03-05 发布日期:2024-02-22
通讯作者: ^*:wangfei0126@126.com
基金资助:
上海市闵行区自然科学研究课题项目(2021MHZ096)

Intensive phototherapy don't affect cellular immune function and short-term reactions after discharge in neonatal hyperbilirubinemia

LIU Zhen¹, WANG Dalian¹, ZHANG Jie², ZHANG Qixing¹, WANG Fei^1*

1. Department of Pediatrics; 2. Department of Clinical Laboratory, Shanghai Fifth People′s Hospital, Fudan University, Shanghai 200240, China

Received:2023-10-25 Revised:2024-01-04 Online:2024-03-05 Published:2024-02-22
Contact: ^*:wangfei0126@126.com

摘要/Abstract

摘要： 目的探讨强光疗对高胆红素血症患儿细胞免疫功能及近期免疫不良反应的影响。方法对180例高胆红素血症患儿给予不同光照强度治疗,对其疗效、细胞免疫功能、出院6个月内的免疫不良反应进行比较。结果光疗后,两组患儿血清白细胞介素(IL-6)均较光疗前降低,CD4⁺(%)、CD4⁺/CD8⁺较光疗前升高。强光组总胆红素下降速度明显快于传统光组,总光疗时间、住院时间均短于传统光组(P＜0.05)。住院期间两组患儿腹泻、皮疹、发热、低钙血症发生率及出院后6个月内免疫相关不良反应的发生率差异均无统计学意义。结论对比传统光疗,强光疗可以更快的降低血清胆红素水平、缩短光疗及住院时间,未增加患儿住院期间常见不良反应及出院后6个月内免疫相关不良反应的发生率。

关键词: 高胆红素血症, 强光疗, 新生儿, 细胞免疫, 不良反应

Abstract: Objective To investigate the effect of intensive phototherapy for neonatal hyperbilirubinemia on cellular immune function and short-term immune-related adverse effects. Methods Totally 180 infants with hyperbilirubinemia were treated with different light intensity, the efficacy, cellular immune function and immune adverse effects were followed up for six months after discharge. Results After phototherapy, serum interleukin-6 (IL-6) in both groups were decreased and CD4⁺ (%) and CD4⁺/CD8⁺ were increased than that before phototherapy. The decrease rate of total bilirubin in the intensive phototherapy group was significantly faster than that in the conventional phototherapy group, at the same time, the total duration of phototherapy and hospital stay were significantly shorter than that in the conventional phototherapy group (P＜0.05). No statistical significance in the incidence of diarrhea, rash, fever and hypo-calcemia during hospitalization and no immune-related adverse effects in 6 months after discharge were recorded. Conclusions Compared with conventional phototherapy, intensive phototherapy reduces serum bilirubin level more quickly and shorten the duration of phototherapy and hospital stay. No common adverse effects nor immune-related adverse effects are recorded during hospitalization and the period of six months after discharge.

Key words: hyperbilirubinemia, intensive phototherapy, neonate, cellular immunity, adverse reaction

中图分类号:

R722

刘珍, 王大连, 张婕, 张其星, 王斐. 强光疗不影响高胆红素血症新生儿细胞免疫功能及出院后近期免疫反应[J]. 基础医学与临床, 2024, 44(3): 379-383.

LIU Zhen, WANG Dalian, ZHANG Jie, ZHANG Qixing, WANG Fei. Intensive phototherapy don't affect cellular immune function and short-term reactions after discharge in neonatal hyperbilirubinemia[J]. Basic & Clinical Medicine, 2024, 44(3): 379-383.

参考文献 12

[1]	黄家虎, 孙建华, 贝斐, 等. 新生儿高胆红素血症风险预测的区域性研究[J].中华新生儿科杂志,2021,36:30-34.
[2]	Merino-Andrés J, Pérez-Nombela S, Álvarez-Bueno C, et al. Neonatal hyperbilirubinemia and repercussions on neurodevelopment: a systematic review[J]. Child Care Health Dev. Published online October 16, 2023. doi:10.1111/cch.13183.
[3]	杨静丽, 王建辉. 2022版美国儿科学会新生儿高胆红素血症管理指南解读[J].中国当代儿科杂志,2023,25:11-17.
[4]	American academy of pediatrics subcommittee on hyperbilirubinemia. Management of hyperbilirubinemia in the newborn infant 35 or more weeks of gestation[J]. Pediatrics, 2004,114:297-316.
[5]	罗桐, 田雯, 卢薇, 等. 强光疗治疗新生儿高胆红素血症的Meta分析[J].中国优生与遗传杂志,2022,30:1199-1204.
[6]	Faulhaber F, Faulhaber G, Marcondes NA, et al. Expression of neutrophil surface markers in icteric neonates before and after phototherapy[J]. Cytometry B Clin Cytom, 2018,94:895-900.
[7]	中华医学会儿科学分会新生儿学组, 《中华儿科杂志》编辑委员会. 新生儿高胆红素血症诊断和治疗专家共识[J].中华儿科杂志,2014,52:745-748.
[8]	王天有, 申昆玲, 沈颖. 褚福堂实用儿科学(第9版)[M]. 北京:人民卫生出版社,2022: 403, 722, 941, 1247.
[9]	郭明, 郭果, 黄玲, 等. 发光二极管蓝光灯在不同方式下的光照强度研究[J].中华新生儿科杂志,2021,36:50-52.
[10]	冯霄. 新生儿高胆红素血症光疗不良反应研究进展[J].临床儿科杂志,2020,38:711-715.
[11]	Oulee A, Ahn GS, Javadi SS, et al. Phototherapy and DNA damage: a systematic review[J]. J Clin Aesthet Dermatol, 2023,16:55-58.
[12]	Yahia S, Shabaan AE, Gouida M, et al. Influence of hyperbilirubinemia and phototherapy on markers of genotoxicity and apoptosis in full-term infants[J]. Eur J Pediatr, 2015,174:459-464.

强光疗不影响高胆红素血症新生儿细胞免疫功能及出院后近期免疫反应

Intensive phototherapy don't affect cellular immune function and short-term reactions after discharge in neonatal hyperbilirubinemia

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