IL-23/IL-17炎性反应轴与HBV宫内感染的相关性研究  

Study on the correlation between IL-23/IL-17 inflammatory response axis and HBV intrauterine infection

作　　者：王兰芳[1] 高智莲 葛晓伟 张倩[1] 张静[2] 吴秀梅 陈先侠[2] Wang Lanfang;Gao Zhilian;Ge Xiaowei;Zhang Qian;Zhang Jing;Wu Xiumei;Chen Xianxia(Department of Clinical Laboratory,Anhui Maternal and Child Health Hospital/Maternal and Child Health Care Hospital Affiliated to Anhui Medical University,Anhui Province,Hefei 230001,China)

机构地区：[1]安徽省妇幼保健院/安徽医科大学附属妇幼保健院检验科,230001 [2]安徽省妇幼保健院/安徽医科大学附属妇幼保健院产科,230001

出　　处：《疑难病杂志》2020年第10期1033-1037,1041,共6页Chinese Journal of Difficult and Complicated Cases

基　　金：安徽省自然科学基金资助项目(1808084MH029)。

摘　　要：目的分析乙型肝炎病毒(HBV)宫内感染患者血清白介素-23(IL-23)/IL-17的水平及其与HBV宫内感染的相关性。方法选择2018年8月—2019年9月安徽省妇幼保健院/安徽医科大学附属妇幼保健院产科住院分娩的HBsAg阳性孕妇120例为研究组,根据新生儿及脐带血HBV-DNA结果分为宫内感染亚组(n=18)和宫内未感染亚组(n=102)。选择同期来院体检健康孕妇120例为健康对照组。比较2组外周血Treg和Th17细胞表达,孕妇及新生儿脐带血清IL-17、IL-23、IL-6及干扰素-γ(IFN-γ),新生儿脐带血清HBV-DNA水平;采用Pearson法分析孕妇血清IL-23/IL-17炎性反应轴与宫内炎性细胞因子的相关性;ROC曲线分析孕妇血清IL-17、IL-23及两者联合对HBV宫内感染的临床诊断价值。结果研究组HBV-DNA阳性率高于健康对照组(χ^2/P=19.459/0.000)。宫内未感染亚组及宫内感染亚组孕妇血Treg和Th17比率均高于健康对照组(F/P=54.947/0.000、97.361/0.000),且宫内感染亚组高于宫内未感染亚组(P<0.05)。与健康对照组比较,宫内未感染亚组孕妇血清IL-17、IL-23、IL-6、IFN-γ水平差异无统计学意义(P>0.05);与健康对照组和宫内未感染亚组比较,宫内感染亚组孕妇血清IL-17、IL-23、IL-6水平显著升高,血清IFN-γ水平显著降低(F/P=1074.615/0.000、767.897/0.000、99.554/0.000、106.961/0.000)。各组新生儿脐带血清IL-17、IL-23、IL-6、IFN-γ水平比较差异无统计学意义(P>0.05)。孕妇血清IL-23、IL-17、IL-6、Treg细胞及Th17细胞各因子间均呈显著正相关,与IFN-γ均呈显著负相关(P均=0.000)。ROC曲线分析结果显示,孕妇血清IL-17、IL-23及二者联合诊断HBV宫内感染的AUC分别为0.791、0.693、0.803,敏感度为63.20%、57.90%、78.90%,特异度分别为94.10%、94.10%、79.20%,约登指数分别为0.573、0.520、0.581。结论孕妇血清IL-23、IL-17表达升高与HBV宫内感染密切相关,对间接判断HBV感染程度具有重要价值。Objective To analyze the levels of serum interleukin 23(IL-23)/IL-17 in patients with hepatitis B virus(HBV)intrauterine infection and its correlation with HBV intrauterine infection.Methods From August 2018 to September 2019,120 HBsAg-positive pregnant women who gave birth in the Obstetric Department of Anhui Maternity and Child Health Hospital/Affiliated Maternity and Child Health Hospital of Anhui Medical University were selected as the research group,and were divided into intrauterine infections according to the HBV-DNA results of newborns and cord blood Subgroup(n=18)and subgroup without intrauterine infection(n=102).120 healthy pregnant women who came to the hospital for physical examination during the same period were selected as the healthy control group.To compare the expression of Treg and Th17 cells in the peripheral blood of the two groups,the umbilical cord serum IL-17,IL-23,IL-6 and interferonγ(IFN-γ)of pregnant women and newborns,and the HBV-DNA level of newborn umbilical cord serum;Pearson method was used to analyze the serum IL-23 of pregnant women/IL-17 inflammatory response axis and intrauterine inflammatory cytokines;ROC curve analysis of the clinical diagnostic value of pregnant women's serum IL-17,IL-23 and the combination of the two for HBV intrauterine infection.Results The positive rate of HBV-DNA in the study group was higher than that in the healthy control group(χ^2/P=19.459/0.000).The blood Treg and Th17 ratios of pregnant women in the subgroup without intrauterine infection and subgroup with intrauterine infection were higher than those in the healthy control group(F/P=54.947/0.000,97.361/0.000),and the subgroup with intrauterine infection was higher than that of the subgroup without intrauterine infection Subgroup(P<0.05).Compared with the healthy control group,there was no significant difference in serum IL-17,IL-23,IL-6,and IFN-γlevels in the subgroup of pregnant women without intrauterine infection(P>0.05);compared with the healthy control group and the subgroup without intra

关 键 词：乙型肝炎病毒 白介素-23 白介素-17 宫内感染 相关性 

分 类 号：R714.251[医药卫生—妇产科学]