乙型肝炎病毒感染孕妇IL-18对Th1/Th2细胞免疫平衡的作用与胎儿宫内感染相关性研究

Relationship between the effects on immune balance of helper T cell 1,2(Th1/Th2) by serum interleukin-18(IL-18) level of pregnant women with hepatitis B virus and intrauterine infection.

目的:探讨乙型肝炎病毒(HBV)感染孕妇外周血白细胞介素-18(IL-18)水平对Th1/Th2细胞免疫的平衡作用与胎儿宫内感染的相关性。方法:选择2006年1月至2006年10月在本院分娩孕产妇101例,合并HBV感染、肝功能正常,单胎、足月妊娠。检测新生儿脐血HBV-DNA及HBsAg,诊断胎儿宫内感染21例为研究组,无宫内感染80例为对照组。用双抗夹心酶联免疫吸附法(DAS-ELISA)检测孕妇外周血清IL-18、IFN-γ(γ-干扰素)、IL-4的水平。结果:(1)研究组孕妇外周血IL-18及IFN-γ明显低于对照组,而IL-4水平明显高于对照组,两组差异有统计学意义(P<0.05,P<0.01,P<0.05);研究组IFN-γ/IL-4比值较对照组明显降低,差异有统计学意义(P<0.01)。(2)两组孕妇外周血IL-18与IFN-γ均呈显著正相关、与IL-4水平均呈显著负相关、与IFN-γ/IL-4比值均呈显著正相关。结论:HBV宫内感染与孕妇Thl型特异性反应降低以及Th2型特异性反应增强有关,Th1/Th2免疫平衡失调可能是胎儿HBV宫内感染的机制之一;HBV宫内感染与孕妇外周血IL-18分泌下降有关,IL-18水平下调可能是HBV宫内感染的危险因素之一。

Objective：To study the relationship between the effects on immune balance of Thl/Th2 by serum IL-18 level of pregnant women with hepatitis B virus and intrauterine infection. Methods：A total of 101 asymptomatic pregnant women with HBsAg and HBeAg positive were re- cruited for the study. Study group consisted of 21 cases for the newborns with intrauterine infection and control group consisted of 80 cases for newborns unintrauterine infection. The women of the two groups were both detected for interleukin-18,interferon-γ ,interleukin-4 of serum prior to delivery by ELISA. Results： （1） The serum mean IL-18,IFN-γ levels of pregnant women in study group was significandy lower than that of the control;but IL-4 levels was significantly higher than that of the control （P 〈0.05,P 〈0.01 ,P 〈0.05） ;The ratio of serum IFN-γ/IL-4 levels of pregnant women in study group was significandy lower than that of the control （P 〈0.01 ）. （2） The positive correlation existed between IL-18 and IFN-γ in two groups;the negative correlation existed between IL-18 and IL-4 in two groups. The positive correlation existed between IL-18 and the ratio of IFN-γ/IL-4 in two groups. Condusion：HBV intrauterine infection is related to the decrease of Thl cell activity and in- crease of Th2 cell activity. HBV intrauterine infection is related to the decrease of IL-18 ,the decrease of serum IL-18 maybe one of the risk factor of HBV intrauterine infection.