患有败血症的早产儿和足月儿的中性粒细胞趋化性与随机迁移

Türkmen M, Satar M, Atici A

Department of Pediatrics, Adnan Menderes University Medical Faculty, Aydin, Turkey.

Am J Perinatol. 2000;17(2):107-12. doi: 10.1055/s-2000-9507.

The aim of this study was to evaluate neutrophil chemotaxis and random migration in healthy newborn infants and septic neonates with similar gestational and postnatal age. Possible relationships between chemotactic activity, random migration, causative microorganisms, and clinical course of septic infants were also investigated. The neutrophil chemotaxis and random migration was evaluated in 24 healthy newborn babies and 34 septic neonates and 20 healthy adults by modified Boyden technique. The mean neutrophil chemotaxis of healthy preterm-term infants and adults were similar (66.6 +/- 18.9, 64.4 +/- 19.9, and 74.7 +/- 17 microm, respectively). The mean neutrophil random migration of healthy term infants was not different than that of adults. But the mean neutrophil random migration of healthy preterm infants was lower than that of adults (36.9 +/- 13.7 and 43.5 +/- 1 1.8 microm, respectively) (p = 0.03). The mean neutrophil chemotaxis and random migration septic term infants were not different from the value of healthy term infants (p > 0.05). Although the mean random migration of septic and preterm infants were similar (p > 0.05), the mean neutrophil chemotaxis of septic preterm infants was lower than the value of healthy preterm infants (p = 0.04). Not only mean neutrophil chemotaxis of septic preterm and term infants were significantly lower than that of adults (p = 0.002 and p = 0.006, respectively), but also neutrophil random migration of septic preterm and term infants were significantly lower than that of adults (p = 0.001 and p = 0.005, respectively). There was no relationship between the nature of causative microorganism and neutrophil random migration or chemotactic activity. Polymorphonuclear leukocytes chemotaxis was significantly lower in preterm with sepsis compared with healthy preterm-term infants and adults. These findings may indicate deterioration in neutrophil functions in premature babies under stress but more detailed studies with larger groups are needed.

本研究旨在评估胎龄和出生后年龄相似的健康新生儿和脓毒症新生儿的中性粒细胞趋化性和随机迁移能力。还研究了趋化活性、随机迁移、致病微生物与脓毒症婴儿临床病程之间的可能关系。采用改良的博伊登技术，对24名健康新生儿、34名脓毒症新生儿和20名健康成年人的中性粒细胞趋化性和随机迁移能力进行了评估。健康早产儿和成年人的中性粒细胞平均趋化性相似（分别为66.6±18.9、64.4±19.9和74.7±17微米）。健康足月儿的中性粒细胞平均随机迁移与成年人无差异。但健康早产儿的中性粒细胞平均随机迁移低于成年人（分别为36.9±13.7和43.5±11.8微米）（p = 0.03）。脓毒症足月儿的中性粒细胞平均趋化性和随机迁移与健康足月儿的值无差异（p>0.05）。虽然脓毒症早产儿和足月儿的平均随机迁移相似（p>0.05），但脓毒症早产儿的中性粒细胞平均趋化性低于健康早产儿的值（p = 0.04）。脓毒症早产儿和足月儿的中性粒细胞平均趋化性不仅显著低于成年人（分别为p = 0.002和p = 0.006），而且脓毒症早产儿和足月儿的中性粒细胞随机迁移也显著低于成年人（分别为p = 0.001和p = 0.005）。致病微生物的性质与中性粒细胞随机迁移或趋化活性之间无相关性。与健康早产儿和成年人相比，脓毒症早产儿的多形核白细胞趋化性显著降低。这些发现可能表明应激状态下早产儿中性粒细胞功能恶化，但需要对更大规模的群体进行更详细的研究。