| BackgroundWith the development of perinatal medicine and the improvement of neonatal intensive care technology,the survival rate of premature infants has been greatly improved,and the incidence of complications related to preterm birth,especially bronchopulmonary dysplasia(BPD),has also been increasing.BPD is a common chronic respiratory disease in premature infants,with a high fatality rate in early stage and a high rate of re-hospitalization in late stage;and the survivors often have abnormal pulmonary function.The pathogenesis of BPD is complex,among which immune imbalance and inflammatory response may play a crucial role.The relationship between BPD and immune response mediated by T lymphocyte is not fully understood.ObjectiveTo investigate the correlation between lymphocyte subsets in peripheral blood,especially γδ-T cells,and BPD of preterm infants in order to further clarify the pathogenesis of BPD and to provide a basis for early prediction.MethodsA total of 88 preterm infants with gestational age ≤32 weeks and birth weight≤1500g who were admitted to the NICU of the Third Affiliated Hospital of Zhengzhou University within 24 h after birth from March 2018 to January 2020 were selected.The proportion of γδ-T、CD3+、CD4+、CD8+ and total lymphocyte subsets in peripheral blood in the early postnatal period(within 24 h)and late postnatal period(3-4 weeks)were detected by flow cytometry.Groups:(1)The subjects were divided into non-BPD group and BPD group according to whether they were given oxygen at 28 days after birth and the degree of oxygen intake corrected for gestational age at 36 weeks,to analyze the relationship between BPD and lymphocyte subsets in peripheral blood of preterm infants at different postnatal periods.The premature infants with BPD were divided into the groups of premature rupture of membranes,iatrogenic preterm delivery and spontaneous preterm delivery according to the causes of preterm delivery,to analyze the relationship between preterm factors and lymphocyte subsets in peripheral blood of early postnatal period of preterm infants.(2)The preterm infants were followed up to investigate the relationship between the recent outcomes of preterm infants at corrected age of 6 months and 12 months and the lymphocyte subsets in early postnatal peripheral blood.Results1.There were no significant differences in the distribution of lymphocyte subsets between BPD and non-BPD groups in the peripheral blood within 24 h after birth of preterm infants(P > 0.05).However,the proportion of γδ-T lymphocytes in the peripheral blood within 3-4 weeks after birth in BPD group was significantly higher than non-BPD group(t=2.609,P=0.017).2.There were no significant differences among preterm rupture membrane group,iatrogenous preterm delivery group and spontaneous preterm delivery group in γδ-T,CD4 +,CD8 +,CD3+ and total lymphocytes in early postpartum peripheral blood of BPD group(P > 0.05).3.There was no significant difference in the levels of γδ-T and other lymphocyte subsets in the early postnatal peripheral blood of preterm infants between normal development group,cerebral palsy/backward development group and death group at12 months of corrected gestational age(P>0.05).ConclusionsIt seems that γδ-T lymphocytes in peripheral blood are closely correlated with BPD.However,the causality of BPD and various lymphocytes remains unclear.BackgroundBoth bronchopulmonary dysplasia and white matter injury are important complications in premature infants,affecting the quality of life of premature infants.There are similarities in pathogenesis of BPD and white matter injury.The infants with BPD are prone to have neurological development disorders,which often lead to cognitive impairment and motor retardation in premature infants.In severe cases,cerebral palsy may occur and even lead to death of the infants.Therefore,there are great clinical significances to evaluate the early development of the nervous system in premature infants with BPD.ObjectiveTo quantitatively assess white matter development in the early postnatal period(during hospitalization)in preterm infants with bronchopulmonary dysplasia(BPD)using the values of diffusion tensor imaging(DTI)in order to explore the levels of white matter development.MethodsA total of 96 preterm infants with the gestational age ≤32 weeks and birth weight < 1500 g who were admitted to the NICU of the Third Affiliated Hospital of Zhengzhou University within 24 hours after birth from August 2016 to April 2019 and completed the examinations of MRI and DTI before discharge were enrolled.Groups: The infants were divided into BPD group(n=48)and non-BPD group(n=48)according to the duration and degree of oxygen dependence.(1)To analyze the differences of different types of brain injury between BPD and non-BPD groups.(2)The two groups were compared in terms of FA and ADC values of the same regions of interest on DTI imageResults1.There were no significant differences in the incidence rates of periventricular / intraventricular hemorrhage,periventricular leukomalacia,and punctate white matter lesions between the two groups(P>0.05).2.Compared with the non-BPD group,the BPD group had significantly lower FA values and significantly higher ADC values of the posterior limb of the internal capsule,the splenium of the corpus callosum,the occipital white matter,the cerebellum,and the cerebral peduncle(P<0.05).ConclusionsThe premature infants with BPD have delayed white matter development.Therefore,it is necessary to pay attention to the neurological function of these infants. |
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