HBeAg与乙型肝炎病毒宫内感染的关系  

Relationship between HBeAg and intra-uterine vertical transmission of hepatitis B virus

作　　者：马丽娟[1] 马玉燕[1] 王磊一[1] 田美荣[1] 高凌雪[1] 刘振平[1] 

机构地区：[1]山东大学齐鲁医院妇产科,济南250012

出　　处：《山东大学学报（医学版）》2008年第5期528-530,534,共4页Journal of Shandong University:Health Sciences

摘　　要：目的探讨乙肝病毒e抗原(HBeAg)对胎儿免疫机制的影响及引起乙肝病毒(HBV)宫内垂直传播和免疫耐受的机制。方法将50例HBsAg阳性孕妇分娩的新生儿分为HBeAg阳性组和HBeAg阴性组,对母血和脐血进行HBV血清学标志物和HBVDNA的检查,并检测脐血中白细胞介素-2(IL-2)、干扰素-γ(IFN-γ)、白细胞介素-4(IL-4)和白细胞介素-6(IL-6)水平,同时设立正常对照组。结果孕妇HBeAg阳性和阴性者分别为27例和23例,其新生儿脐血HBeAg阳性者分别为22例和1例,差异具有统计学意义(P<0.05);与新生儿HBeAg阴性组(27例)和正常对照组相比,新生儿HBeAg阳性组(23例)脐血IL-2、IFN-γ水平明显降低,而IL-4、IL-6水平明显升高,差异具有统计学意义(P<0.05),新生儿HBeAg阴性组(27例)和正常对照组间四种细胞因子水平差异均无统计学意义(P>0.05)。结论胎儿体内的HBeAg可由母体传播而来,并可能通过Th1/Th2细胞亚群失衡引起胎儿机体对HBV的免疫耐受及宫内感染的发生。Objective To investigate the effect of HBeAg on immunologic state of neonates and the mechanisms of intra-uterine infection and immunotolerance of hepatitis B virus. Methods 50 neonates delivered by positive HBsAg mothers were divided into the positive HBeAg group and the negative HBeAg group. The serum HBV M and HBV DNA were determined in pregnant women and neonates, also the levels of IFN-γ, IL-2, IL-4 and IL-6 in these neonates and another 20 normal neonates were determined. Results 27 pregnant women had positive HBeAg and 23 had negative HBeAg, and of them 22 and 1 neonate had positive HBeAg（ P 〈 0.05） . Compared with the negative HBeAg group （27cases） and the control group,the IL-2 and IFN-7 levels of the positive HBeAg group （23cases） were significantly decreased while the IL-4 and IL-6 levels were significantly increased（ P 〈 0.05）, but the cytokine levels were not significantly different between the negative HBeAg group and the control group （ P 〉 0.05）. Condusion Neonate HBeAg can be transmitted from positive HBsAg pregnant woman, which may cause an unbalance of the Th1/Th2 cell subset and bring on the immunotolerance of hepatitis B virus, and finally causes intra-uterine infection of HBV.

关 键 词：肝炎e抗原 乙型 垂直传播 免疫耐受 

分 类 号：R714.255[医药卫生—妇产科学]