乙型肝炎病毒宫内感染儿童干扰素-γ、白细胞介素-4水平变化研究

Study of IFN-γ,IL-4 levels of the neonates with HBV intrauterine infection

目的分析乙型肝炎病毒（HBV）宫内感染儿童干扰素-γ（IFN-γ）、白细胞介素4（IL-4）水平变化。方法采用双抗夹心EHSA法检测HBV宫内感染21例及宫内未感染25例脐血IFN-KIL4并追踪检测其1周岁时外周静脉血血清中乙型肝炎指标及IFN-γ、IL-4水平。结果出生时，宫内感染组及未感染组IFN-γ[（12．23±2．41）与（12．91±2．38）ng／L]及IL-4[（21．37±2．13）与（21．14±2．15）ng／L]水平比较，差异无统计学意义（P〉0．05）。9例儿童1岁时HBsAg阳性，抗HBs≤10mIU，免疫失败。宫内未感染组及免疫有效组IFN-γ水平增加高于免疫失败组[（39．05±6．92）、（36．21±6．45）、（23．40±4．12）ng／L]，差异有统计学意义（均P〈0.05）。3组IL-4增加均不明显，差异无统计学意义[（30．06±9．01）、（28．53±8．49）、（26．51±4.67）ng／L，P〉0．05]。结论新生儿细胞因子水平低下，1岁时1型细胞因子分泌不足可能是宫内感染HBV导致乙肝疫苗免疫失败的原因之一。

Objective To study the IFN-γ and IL-4 levels of the neonates with hepatitis B virus（HBV） intrauterine infection. Methods 21 cases developed HBV intrauterine infection and 25 cases did not develop HBV intrauterine infection. The cord blood IFN-γ, IL-4 levels and the serum HBV markers, IFN-γ, IL-4 levels in neonates at one year were determined by using diantibody sandwich enzyme linked immuneadsorb assay （ DAS-ELISA ） , respectively. Results There was no significant difference in IFN-γ[ （ 12.23 ± 2.41 ） vs. （ 12.91 ± 2.38 ） ng/L], IL-4 [ （ 21.37 ± 2.13 ） vs. （ 21.14 ± 2.15 ） ng/L] levels between neonates with intrauterine infection, and those without intrauterine infection in newborns （P 〉 0.05 ）. At one year, the anti-HBS level was ≤ 10 mIU in 10 neonates who were positive in HBsAg. The IFN-γ levels of neonates without intrauterine infection and those with actively inocdated were significantly higher than those with passively inoculated [ （39.05 ± 6.92）, （36.21 ± 6.45）, （23.40 ± 4.12） ng/L] （ P 〈 0.05 ）. There was no significant difference in IL-4 levels among the 3 groups [ （ 30.06 ± 9.01 ） , （ 28.53 ± 8.49 ）, （ 26.51 ± 4.67 ） ng/L] （ P 〉 0.05 ）. Conclusion The low level of cytokines in neonates and the decrease of 1 style cytokines level at one year may play a role in the mechanism of immunized failure.