HBsAg阳性孕妇IL-4的表达在HBV宫内传播中的作用  

Role of IL-4 expression in HBsAg positive pregnant women in intrauterine transmission of HBV

作　　者：邵昱璋 王海荣 续靖宁 严敏 付婷 张磊 SHAO Yuzhang;WANG Hairong;XU Jingning;YAN Min;FU Ting;ZHANG Lei(Xi'anJiaotong University (Medical College),Xi'an,Shaanxi 710061,China)

机构地区：[1]西安交通大学医学院,陕西西安710061 [2]空军军医大学军事预防医学系流行病学教研室,特殊作业环境危害评估与防治教育部重点实验室,陕西西安710032 [3]西北妇女儿童医院,陕西西安710061

出　　处：《中国热带医学》2019年第10期926-930,共5页China Tropical Medicine

基　　金：国家自然科学基金(No.81102140,81472988);国家重点研发计划(No.2016YFC1303204)

摘　　要：目的探讨HBsAg阳性孕妇外周血IL-4水平在乙型肝炎病毒(HBV)宫内传播中的表达变化。方法以陕西省西北妇女儿童医院住院分娩的306例HBsAg阳性孕妇为病例组,74例健康孕妇为对照组进行流行病学调查,采用ELISA法检测孕妇和新生儿外周血乙型肝炎5项指标,采用实时荧光定量PCR检测HBVDNA水平,采用流式液相芯片法检测细胞因子IL-4水平。结果HBsAg阳性孕妇发生HBV宫内显性感染(DBI)、HBV宫内隐匿性感染(OBI)和HBV宫内传播(BIT)率为11.44%(35/306)、36.60%(112/306)、48.04%(147/306)。对照孕妇IL-4水平低于HBsAg阳性孕妇组、HBV宫内未传播组(NBIT)、显性感染组(DBI)和隐匿性感染组(OBI),差异均有统计学意义(均有P<0.01);HBeAg阴性组中DBI组的IL-4水平高于OBI组和HBIT组,差异有统计学意义(P<0.05);随着母血中HBVDNA载量的增高,DBI组IL-4水平呈下降趋势(P<0.05),在HBVDNA载量小于103IU/mL时,DBI组IL-4水平高于OBI组(P<0.05)和NBIT组(P<0.01),并且随着BIT程度的加重,母血中IL-4水平呈增高趋势(P<0.05);多因素分析显示:孕妇HBeAg和HBVDNA载量与其IL-4水平呈正相关;孕妇HBeAb与其IL-4水平呈负相关。结论HBsAg阳性孕妇细胞免疫功能紊乱导致IL-4水平升高,开展HBsAg阳性孕妇外周血IL-4监测对其新生儿是否发生HBV宫内传播可能具有一定预测作用。Objective To investigate the expression of IL-4 in peripheral blood of HBsAg positive parturients in intrauterine transmission of hepatitis B virus(BIT).Methods Epidemiological investigation was carried out on 306 HBsAg positive parturients delivered in Northwest Women and Children's Hospital of Shaanxi Province and 74 health parturientsas control group.Enzyme-linked immunosorbent assay(ELISA)was used to detect five makers of hepatitis B,real time PCR was used to detect HBV-DNA,and flow liquid chip method was used to detect IL-4 in peripheral blood of pregnant women and newborns.Results The incidence of dominant HBV infection(DBI),occult HBV infection(OBI)and BIT were 11.44%(35/306),36.60%(112/306)and 48.04%(147/306),respectively.The levels of IL-4 in peripheral blood of HBsAg-negative parturients were significantly lower than those of HBsAg-positive parturients,NBIT group,DBI group,and OBI group(P<0.01).The level of IL-4 in HBeAg negative group of DBI group was significantly higher than that in OBI group(P<0.05)and HBIT group(P<0.05).With the increase of HBV DNA load in maternal blood,the level of IL-4 in DBI group descended(P<0.05).When HBV DNA load was smaller than 103 IU/mL,the level of IL-4 in DBI group was significantly higher than OBI group(P<0.05)and NBIT group(P<0.01),and descended with the increase of BIT.The level of maternal IL-4 had positive relation to the maternal HBeAg status and HBV DNA load in maternal blood.The level of maternal IL-4 had negative relation to the maternal HBeAb status in maternal blood.Conclusions There is imbalance of Th1/Th2 cells in pregnant women,which causes the activity of IL-4 increases.Monitoring the level of IL-4 in HBsAg-positive pregnant women can predict the probability of HBV intrauterinetransmission.

关 键 词：乙肝病毒宫内传播 乙肝病毒宫内显性感染 乙肝病毒宫内隐匿性感染 白介素4 

分 类 号：R512.62[医药卫生—内科学]