Relationship Between Th1/Th2 Shift and Disease Severity in Children with Neonatal Respiratory Distress Syndrome

HUI Xiaojun; QI Yumin; TIAN Jing; WANG Pin; CHEN Keyun

doi:10.3969/j.issn.1004-437X.2025.01.012

Abstract：Objective To explore the relationship between T helper 1/T helper 2(Th1/Th2)shift and severity of disease in children patients with neonatal respiratory distress syndrome(NRDS).Methods A total of 117 children patients with NRDS admitted between January 2018 and March 2021 were selected and divided into mild group(62 cases)and severe group(55 cases).The expression rates of Th1 cells and Th2 cells before treatment,and the Th1/Th2 value,critical disease condition and respiratory function parameters[arterial partial pressure of oxygen(PaO2),partial pressure of carbon dioxide(PaCO2),oxygenation index(OI),PaO2/alveolar partial pressure of oxygen(PaO2/PAO2)]were compared between the two groups.Pearson correlation analysis method was used to evaluate the correlation between Th1/Th2 value and NCIS score and respiratory function parameters.According to the prognosis status of children patients receiving standardized diagnosis and treatment,they were divided intogood prognosis group and poor prognosis group.The changes in Th1/Th2 value were observed ingood prognosis group and poor prognosis group at different time points of treatment.Receiver operating characteristic(ROC)curve was drawn to evaluate the predictive value of Th1/Th2 value on prognosis of children patients.Results(1)The peripheral blood Th1 level and Th1/Th2 in severe group were higher compared to mild group before treatment(P＜0.05).(2)The NCIS score of severe group was significantly lower than that of mild group.The respiratory function parameters of PaO2 and PaO2/PAO2 were decreased compared with those in mild group while the PaCO2 and OI were increased compared to mild group(P＜0.05).(3)Pearson correlation analysis showed that Th1/Th2 value was negatively correlated with NCIS score and PaO2(r=-0.312,-0.404,P＜0.05),and was positively correlated with PaCO2 and OI(r=0.228,0.276,P＜0.05),but was not significantly correlated with PaO2/PAO2(P＞0.05).(4)Twenty-five of the 117 children were with poor prognosis in the hospital,and the poor prognosis rate in severe group was higher than that in mild group(P＜0.05).(5)The peripheral blood Th1/Th2 values of good prognosis group before treatment and at 1 day and 3 days after treatment were lower than those of poor prognosis group,but the peripheral blood Th1/Th2 value in poor prognosis group at the last detection was lower than that in good prognosis group.(6)The area under the ROC curve(AUC)of Th1/Th2 value before treatment in predicting the poor prognosis children patients was 0.835.Conclusion Th1/Th2 shift is correlated with the severity of disease and respiratory function in children patients with NRDS,and it has a certain predictive value on the prognosis of children patients.