围产期产妇感染乙肝病毒对新生儿脐带血免疫因子、淋巴细胞亚群的影响

Effects of perinatal maternal infection of hepatitis B virus on neonatal umbilical cord blood immune factor and lymphocyte subsets

目的探究围产期产妇感染乙型肝炎(以下简称乙肝)病毒对新生儿脐带血免疫因子、淋巴细胞亚群的影响,为新生儿乙肝的预防提供理论依据。方法选取彭州市人民医院2015年6月至2016年6月出生的110例新生儿为研究对象,根据产妇围产期是否感染乙肝病毒分为观察组与对照组,每组各55例。取新生儿脐带血分别检测免疫因子血清IgA、IgG、IgM以及淋巴细胞亚群CD3^+、CD4^+、CD8^+、CD19^+,并比较两组新生儿乙肝感染率、肺部感染率、黄疸发生率以及存活情况。结果观察组新生儿IgA、IgM分别为(0.46±0.12)、(0.68±0.23)g/L,均显著高于对照组[(0.21±0.08)、(0.68±0.23)g/L],差异有统计学意义(P<0.05),两组IgG水平差异无统计学意义(P>0.05);观察组CD4^+/CD8^+、CD3^+、CD4^+例显著高于对照组,CD19^+显著低于对照组,差异有统计学意义(P<0.05),CD8^+差异无统计学意义(P>0.05);观察组新生儿存活率96.36%,低于对照组(100.00%),但差异无统计学意义(P>0.05);观察组乙肝感染率、肺部感染率、黄疸发生率分别为41.82%、29.10%、10.10%,显著高于对照组(9.10%、7.27%、0.00%),差异有统计学意义(P<0.05)。结论围产期产妇感染乙肝病毒能显著升高IgA、IgG水平,提高CD3^+、CD4^+、CD4^+/CD8^+,降低CD19^+比例,影响新生儿免疫功能,更易受到病毒感染。

Objective To investigate the effects of perinatal maternal infection of hepatitis B virus on neonatal umbilical cord blood immune factor and lymphocyte subsets,and to provide a theoretical basis for the prevention of neonatal hepatitis B.Methods A total of 110 cases of neonatus in Pengzhou People′s Hospital from June 2015 to June 2016 were selected and divided into the observation group and the control group according to whether the pregnant women were infected with hepatitis B virus in perinatal period or not,each group had 55 cases.Neonatus umbilical cord blood were taken to detected serum immune globulin A（IgA）,G（IgG）,M（IgM）and lymphocyte subsets CD3＋,CD4＋,CD8＋,CD19＋,and the two groups′neonatal hepatitis B infection,lung infection,the incidence of jaundice and survival were compared.Results The observation group′s neonatal IgA and IgM were respectively（0.46±0.12）and（0.68±0.23）g/L,which were significantly higher than those of the control group[（0.21±0.08）,（0.68±0.23）g/L],the differences had statistical significance（P〈0.05）.There were no statistical significance in IgG level between the two groups（P〈0.05）.The observation group′s CD4＋/CD8＋,CD3＋,CD4＋were significantly higher than those of the control group,CD19＋was significantly lower than that of the control group,the differences had statistical significance（P〈0.05）.There was no statistical significance in CD8＋（P〈0.05）.The observation group′s neonatus survival rate was 96.36%,which was lower than that of the control group（100.00%）,but the difference had no statistical significance（P〈0.05）.The observation group′s hepatitis B infection rate,pulmonary infection rate,incidence of jaundice were 41.82%,29.10%,10.10%,which were significantly higher than those of the control group（9.10%,7.27%,0.00%）,the difference had statistical significance（P〈0.05）.ConclusionPerinatal pregnant women infected with hepatitis B virus could sharply increase the level of IgA and IgG,increase the CD3＋,CD4＋,CD4＋/CD8＋,reduce the proportion of CD19＋,affect neonatus immune function,and are more susceptible to viral infection.