呼吸道感染儿童乙肝疫苗应答与细胞免疫水平及临床特征的关系  

Correlation between response to hepatitis B virus vaccine and cellular immunity and clinical characteristics in children with respiratory infection

作　　者：顾文婧[1] 季伟[1] 张新星[1] 陈正荣[1] 严永东[1] 朱灿红[1] 王宇清[1] 黄莉[1] 王美娟[1] 邵雪君[2] 

机构地区：[1]苏州大学附属儿童医院呼吸科,215003 [2]苏州大学附属儿童医院检验科,215003

出　　处：《中华实用儿科临床杂志》2017年第4期275-279,共5页Chinese Journal of Applied Clinical Pediatrics

基　　金：国家自然科学基金（81570016）;国家自然科学基金青年项目（81401296）

摘　　要：目的分析呼吸道感染儿童乙肝疫苗应答情况与细胞免疫水平及临床特征之间的关系。方法选取2015年1月至12月入住苏州大学附属儿童医院呼吸科7月龄以上并完整接种乙肝疫苗的患儿960例。采集外周血1～2 mL，酶联免疫吸附试验及PCR法检测患儿乙肝三对水平，包括乙肝表面抗原、乙肝表面抗体、乙肝e抗原、乙肝e抗体、乙肝核心抗体、乙型肝炎核酸。依据对乙肝疫苗免疫应答情况将患儿分为无应答组、低应答组、正常应答组及高应答组4组，同时行流式细胞术检测患儿细胞免疫水平，并记录患儿的临床资料。结果4组患儿细胞免疫CD3＋CD4＋分别为（3.43±0.28）%、（3.42±0.30）%、（3.43±0.36）%和（3.52±0.29）%，组间比较差异无统计学意义（F＝0.520，P＝0.669）；无应答组患儿CD3＋CD8＋为（3.18±0.28）%，显著高于低应答组、正常应答组及高应答组[（3.08±0.36）%、（3.05±0.34）%、（2.93±0.30）%]，差异均有统计学意义（均P〈0.05）；无应答组患儿CD4/CD8比值为0.26±0.43，显著低于正常应答组（0.40±0.50），差异有统计学意义（P＝0.001）；低应答组、正常应答组和高应答组3组间患儿CD3＋、CD3＋CD8＋和CD4/CD8比较差异均无统计学意义（均P〉0.05）。无应答组患儿CD3－CD19＋和CD19＋CD23＋最低，分别为（3.00±0.57）%和（2.25±0.67）%；高应答组最高，分别为（3.33±0.45）%和（2.57±0.38）%，2组比较差异均有统计学意义（均P〈0.05）。4组患儿中，正常应答组平均住院天数最短[（1.88±0.31） d]，显著低于无应答组、低应答组和高应答组[（1.96±0.39） d、（1.95±0.38） d、（1.96±0.15） d]，差异均有统计学意义（均P〉0.05）；而其余3组患儿平均住院天数比较差异均无统计学意义（均P〉0.05）。无应答组和高应答组患儿重症肺炎比例[6.1%（22/363例）和13.3%（2/15例）]显著高于正常应答组Objective To analyze the correlation between response to hepatitis B virus （HBV） vaccine and cellular immunity and clinical characteristics in children with respiratory infection. Methods Nine hundred and sixty children in Department of Respiratory in Children＇s Hospital of of Soochow University, who were over 7 months old and had full course of HBV vaccination between January and December 2015 were enrolled in this study. Peripheral blood （1 -2 mL） was collected, and antigen -antibody of HBV was detected by using enzyme -linked immunosorbent assay and PCR included HBV surface antigen, hepatitis B antibody, HBV e antigen, HBV e antibody, HBV core antibody, and HBV nucleic acid. According to the results, these children were divided into 4 groups ： non response group,low response group, normal response group and high response group according to their responses to HBV vaccine. Cellular immunity was detected by using flow eytometry and patients＇ clinical data was collected. Results There was no statistical differences of CD3^ ＋ CD4 ^＋ , which were （3.43 ±0.28 ） %, （3.42 ± 0.30） % , （3.43 ±0.36 ） % and （ 3.52 ±0.29 ） % , among the four groups （ F = 0. 520, P = 0. 669）. CD3^＋ CD8^＋ in non response group was （ 3.18 ±0.28 ） %, which was significantly higher than that in low response group, normal response group and high response group [ （ 3.08± 0.36 ） %, （ 3.05 ±0.34） %, （ 2.93 ±0.30） % ] , the differences were significant （ all P 〈 0.05 ） ; CD4/CD8 in non response group （0.26 ±0.43 ） were significantly lower than that in normal response group （0.40 ±0.50）, the differences were significant （P = 0. 001 ）. There was no significant difference of CD3^＋ , CD3^＋CD8^＋ and CD4/CD8 among low response group, normal response group and high response group （ all P 〉 0.05 ）. CD3^ - CD19^ ＋ and CD19^＋ CD23^＋ level were lowest in non response group [ （ 3.00 ± 0.57 ） % , （ 2.25 ±0.67 ） % ] and highest in high response group [

关 键 词：乙肝疫苗 细胞免疫 呼吸道感染 儿童 

分 类 号：R725.1[医药卫生—儿科]