Ahmed I, Rahman K M, Miah R A, Hossain T, Khatoon S, Khatun M
NIPSOM, Mohakhali, Dhaka.
Bangladesh Med Res Counc Bull. 1994 Dec;20(3):99-103.
We studied 125 clinically suspected septicemic neonates (Patient) aged from 1 to 28 days and 25 healthy neonates (control) of comparable age and sexes. Cultures of blood were done and serum immunoglobulins (IgG, IgA) were estimated in all the subjects. Blood cultures were found positive in 45 (36%) patients. Preterm patients showed significantly higher number of positive blood cultures as compared to term patients. The mean serum IgG level in patients was found significantly lower than that of the controls. The serum IgG levels were also found significantly lower in 75 preterm as compared to 50 term, and in 45 blood culture positive patients as compared to 80 blood culture negative patients. On the other hand, the mean serum IgM level in patients was found significantly higher as compared to controls. Similarly, serum IgM levels were found higher in preterm patients as compared to term patients and in blood culture positive patients as compared to blood culture negative patients. No significant difference of mean serum IgA level was found among the subjects. It is evident from our study, that blood culture positive patients were mostly preterm, in whom transplacental passage of IgG is insufficient and due to low IgG level, preterm baby cannot counteract bacterial invasion and as such, suffer from septicemia more frequently. Septicemic neonates as a rule showed higher level of serum IgM due to synthesis by themselves in primary response to infection.
我们研究了125名临床疑似败血症的新生儿(患者),年龄在1至28天之间,以及25名年龄和性别相仿的健康新生儿(对照组)。对所有受试者进行了血培养,并测定了血清免疫球蛋白(IgG、IgA)。45名(36%)患者的血培养结果呈阳性。与足月儿相比,早产儿血培养阳性的数量显著更高。发现患者的平均血清IgG水平显著低于对照组。与50名足月儿相比,75名早产儿的血清IgG水平也显著更低;与80名血培养阴性的患者相比,45名血培养阳性的患者的血清IgG水平也显著更低。另一方面,发现患者的平均血清IgM水平显著高于对照组。同样,与足月儿相比,早产儿的血清IgM水平更高;与血培养阴性的患者相比,血培养阳性的患者的血清IgM水平更高。在受试者中未发现平均血清IgA水平有显著差异。从我们的研究中可以明显看出,血培养阳性的患者大多是早产儿,其IgG的经胎盘传递不足,由于IgG水平低,早产儿无法抵抗细菌入侵,因此更频繁地患败血症。败血症新生儿通常由于在对感染的初次反应中自身合成,血清IgM水平较高。