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Chinese Journal of Clinicians(Electronic Edition) ›› 2018, Vol. 12 ›› Issue (10): 571-575. doi: 10.3877/cma.j.issn.1674-0785.2018.10.008

Special Issue:

• Clinical Research • Previous Articles     Next Articles

Significance of changes of peripheral venous blood T lymphocyte subsets and IL-6 in diagnosis and treatment of neonatal hyperbilirubinemia

Jianmei Zhang1, Fasheng Liu2,(), Xin Chen1, Zhenhua Zhu1   

  1. 1. Department of Pediatrics, the Third Affiliated Hospital of Inner Mongolia Medical College, Baotou 014010, China
    2. Medical Laboratory, the Third Affiliated Hospital of Inner Mongolia Medical College, Baotou 014010, China
  • Received:2018-04-05 Online:2018-05-15 Published:2018-05-15
  • Contact: Fasheng Liu
  • About author:
    Corresponding author: Liu Fasheng, Email:

Abstract:

Objective

To investigate the changes of bilirubin, T-lymphocyte subsets, and interleukin-6 (IL-6) levels in neonatal hyperbilirubinemia and to analyze their clinical significance in the diagnosis and treatment of this condition.

Methods

Forty newborns with hyperbilirubinemia who were hospitalized from January 2015 to December 2015 were randomly selected. According to the treatment methods used, the patients were equally divided into two groups: those undergoing conventional blue light treatment alone (group 1) and those undergoing conventional blue light plus Mamiai treatment (group 2). Twenty age-matched healthy newborns were included as a control group (no jaundice or serum bilirubin levels ≤ 205.2 μmol/ L). The T-lymphocyte subsets and IL-6 levels in peripheral venous blood samples from these neonates were measured, compared, and analyzed.

Results

Before treatment, T-lymphocyte subsets in groups 1 and 2 were all significantly lower than those in the control group [CD3+ : (48.00±5.28)% vs (46.60±5.57)% vs (60.54±4.66)%; CD4+ : (31.05±5.09)% vs (33.50±4.80)% vs (44.86±3.75)%; CD4+ /CD8+ ratio: 0.93±0.21 vs 0.95±0.23 vs 1.32±0.17; P<0.001 for all]; IL-6 levels in groups 1 and 2 were significantly higher than those in the control group [(21.73±2.35) ng/mL vs (22.05±2.58) ng/mL vs (10.85 ±2.11) ng/mL, P<0.001]. After treatment, T-lymphocyte subsets in groups 1 and 2 were still significantly lower than those in the control group [CD3+ : (46.15±7.17)% vs (55.15±6.89)% vs (60.54±4.66)%; CD4+ : (29.45±5.64)% vs (37.85 ±5.49)% vs (44.86 ±3.75)%; CD4+ /CD8+ ratio: 0.92±0.22 vs 1.12±0.25 vs 1.32±0.17, P<0.01], and the levels of IL-6 were still higher than that of the control group [(23.83±3.34) ng/mL vs (14.91±2.31) ng/mL vs (10.85±2.11) ng/mL, P<0.01]. However, CD3+ , CD4+ , and CD4+ /CD8+ ratio were significantly higher and IL-6 level was significantly lower in group 2 than in group 1 (P<0.01). Serum total bilirubin levels were negatively correlated with CD4+ /CD8+ ratio in the hyperbilirubin groups before treatment (r=-0.780, -0.594, P<0.01), but positively correlated with IL-6 level (r=0.752, 0.591, P<0.01).

Conclusion

There is a disturbance of cellular immunity and cytokine secretion in neonates with hyperbilirubinemia. Phototherapy could reduce high indirect bilirubin, but it does not improve the immune function of newborns with hyperbilirubinemia. Oral immunomodulator Mamiai could effectively compensate for the deficiency of phototherapy.

Key words: Hyperbilirubinemia, neonate, T lymphocyte subsets, Interleukin-6

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