摘要目的：观察母亲患变应性鼻炎（allergic rhinitis，AR）对脐带血T细胞亚型的影响，并探讨脐带血T细胞亚型对婴幼儿特应性皮炎（ atopic dermatitis，AD）的预测价值。方法前瞻性纳入70名就诊于北京同仁医院的母亲及其婴幼儿。收集母亲AR病史、分娩年龄、外周血总IgE、血清特异性IgE数据。采集母亲外周血及婴儿脐带血标本，应用流式细胞术分析Th1细胞和Th2细胞数量。随访其0～2岁婴幼儿是否确诊AD。应用多因素Logistic回归和受试者工作特征曲线评价脐带血T细胞亚型对婴幼儿AD的预测价值。结果70名母亲中AR阳性者21例，阴性者49名；其生产的婴幼儿（均为单胎）2岁内AD发病率为15.7％（11例）。母亲AR阳性时，其外周血及其婴儿脐带血中Th2细胞分别为7.10[1.18；16.1]％、1.02[0.57；1.34]％，与母亲 AR 病史阴性的0.37[0.25；0.72]％、0.21[0.15；0.42]％相比显著升高，差异有统计学意义（ U值分别为10.0、127.5， P值均＜0.05）。而脐带血Th1细胞在母亲AR阳性或阴性组分别为0.69[0.40；1.12]％和0.50[0.31；0.66]％，两组间差异无统计学意义（U＝361.0，P＞0.05）。脐带血Th1/Th2比例降低是AD的危险因素（ OR＝1.72，P＝0.001）。 Cox回归分析显示，脐带血Th1/Th2比值、母亲AR病史、分娩年龄、母亲外周血总IgE等预测婴幼儿发生AD的曲线下面积AUC＝0.907（95％可信区间为0.804～1.011， P＜0.001）。结论母亲患AR者，其新生儿脐带血Th2细胞升高。脐带血Th1/Th2失衡是婴幼儿在0～2岁患AD具有预测价值的生物学指标。

abstractsObjective To investigate the influence of maternal atopy on cord blood effector T cells and to identify these biologic markers as predictors of atopic dermatitis ( AD).Methods Seventy mother-infant pairs were recruited in this prospective birth cohort study.Suspected factors for allergy , including maternal allergic history , total serum IgE , and maternal age at birth , were collected.Mother peripheral blood samples and cord blood were obtained and assayed for the percentage of interferon -γ( IFN-γ) and interlukin 4 (IL-4) producing T cells(Th1 and Th2 respectively) using flow cytometry.Their offspring at the age of 2 years old were evaluated by their dermatologist whether they had AD.Statistical analysis was performed using multiple logistic regression models and receiver-operating characteristic curve was employed&nbsp;to predict atopic dermatitis.Results Twenty-one allergic and 49 nonallergic mothers were recruited in this study.During the first two years of life, 15.7%children (n=11) developed a physician-diagnosed AD (all children were the only child in the family ).In group with maternal allergic rhinitis , a significantly increased percentage of Th2 was observed in peripheral blood of mother ( 7.10 [ 1.18;16.1 ]% vs.0.37 [ 0.25;0.72]%, U=10.0, P <0.05 ) and cord blood of newborns ( 1.02 [ 0.57;1.34 ]% vs.0.21 [ 0.15;0.42]%, U=127.5, P<0.05), respectively.Maternal atopic history did not affect the percentage of Th1cells in cord blood (0.69[0.40;1.12]% vs.0.50[0.31;0.66]%, U=361.0, P>0.05).Children with reduced Th1/Th2 ratio in cord blood had a higher risk to develop AD (OR=1.72,P=0.001).The model including Th1/Th2, maternal allergy, maternal age at birth and maternal total IgE showed high ability to discriminate children with and without AD.AUC was 0.907 (95% CI:0.804 -1.011, P<0.001).Conclusions Elevated IL-4 +CD4 +T cells in cord blood were of relevance with maternal allergic history.Imbalance between Th1 cell and Th2 cell at birth are associated with maternal allergy and promoted subsequent AD development.