HBsAg阳性孕妇及新生儿血清IL-6、IL.17、IL-23水平与HBV宫内感染关系

Levels of serum interleukin-6,interleukin-17 and interleukin-23 of pregnant women with hepatitis B surface antigen positive and their neonates and their correlation with the neonatal hepatitis B virus intrauterine infection

目的:探讨乙肝表面抗原(HBsAg)阳性孕妇及新生儿血清白细胞介素(IL)-6、IL-17、IL-23水平与乙肝病毒(HBV)宫内感染关系。方法:回顾性收集2021年1月-2023年12月本院就诊的HBsAg阳性孕妇140例的临床资料为HBsAg阳性组,按照新生儿脐带血检测结果分为宫内感染组(n=28)与未感染组(n=112),同期HBsAg阴性孕妇140例为HBsAg阴性组。比较孕妇孕28周时外周血及新生儿脐血血清IL-6、IL-17、IL-23水平。受试者工作特征(ROC)曲线分析HBsAg阳性孕妇血清IL-6、IL-17、IL-23水平判断HBV宫内感染临床价值。结果:宫内感染组孕妇血清IL-6(104.33±24.92 ng/L)、IL-17(282.65±76.71 ng/L)、IL-23(269.52±64.28 ng/L)水平均高于未感染组(70.34±18.61、123.41±43.02、113.75±41.68)ng/L与HBsAg阴性组(68.13±17.18、119.53±37.13、110.32±44.43)ng/L(均P<0.05),未感染组与HBsAg阴性组无差异(P>0.05),各组新生儿脐带血清IL-6、IL-17、IL-23水平无差异(P>0.05)。ROC曲线分析,HBsAg阳性孕妇血清IL-6、IL-17、IL-23评估HBV宫内感染的曲线下面积分别为0.791、0.725、0.745,敏感度及特异度在61.6%~78.6%,有一定临床参考价值。结论:宫内感染孕妇孕28周时血清IL-6、IL-17、IL-23水平升高,3项指标对判断HBsAg阳性孕妇发生HBV宫内感染风险有一定临床指导价值。

Objective:To explore the levels of serum interleukin(IL)-6,IL-17 and IL-23 of pregnant women with hepatitis B surface antigen(HBsAg) positive and their neonates,and to study their correlation with the neonatal hepatitis B virus(HBV) intrauterine infection.Methods:The clinical data of 140 pregnant women with HBsAg positive(in study group) between January 2021 and December 2023 were collected retrospectively.According to the detection results of the HBsAg in the neonatal cord blood,the pregnant women in the study group were divided into group A(28women with neonatal HBV intrauterine infection) and group B(112 women without neonatal HBV intrauterine infection).Another 140 pregnant women with HBsAg negative were enrolled in control group during the same period.The levels of serum IL-6,IL-17 and IL-23 in peripheral blood of the women and in neonatal cord blood serum were compared among these groups.Receiver operating characteristic(ROC) curve analysis was used to analyze the clinical value of the serum IL-6,IL-17 and IL-23 levels of the pregnant women with HBsAg positive for evaluating their neonatal HBV intrauterine infection.Results:The levels of the serum IL-6(104.33±24.92 ng/L),IL-17(282.65±76.71 ng/L) and IL-23(263.52±64.28 ng/L) of the women in group A were significantly higher than those(70.34±18.61 ng/L,123.41±43.02 ng/L and 113.75±41.68 ng/L) of the women in group B and those(68.13±17.18 ng/L,119.53±37.13 ng/L and 110.32±44.43 ng/L) of the women in the control group(all P <0.05).There were no significant differences in the the serum IL-6,IL-17 and IL-23 levels of the women between group B and the control group(P>0.05).There were no significant differences in the IL-6,IL-17 and IL-23 levels in umbilical cord of the neonates among the three groups(P>0.05).ROC curve analsis showed that the area under the curve of the serum IL-6 level,the IL-17 level and the IL-23 level of the pregnant women with HBsAg-positive for evaluating their neonatal HBV intrauterine infection were 0.791,0.725 and 0.745,respectively,the sensitivity and specificity of which were 61.6%-78.6%,and all of which had certain clinical reference values for evaluating their neonatal HBV intrauterine infection.Conclusion:The levels of serum IL-6,IL-17 and IL-23 of the pregnant women with the neonatal HBV intrauterine infection increase,and all of which have certain clinical guiding value for evaluating the risk of the neonatal HBV intrauterine infection of the women.