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目的通过对宫内感染乙型肝炎病毒(HBV)新生儿T淋巴细胞亚群的检测,探讨宫内感染免疫失败的机制,为以后免疫干预提供理论依据。方法选择2003-03-2003-07在东南大学附属南京市第二医院分娩的90例HBsAg阳性孕妇的新生儿,实施母婴联合免疫,于注射乙型肝炎免疫球蛋白(HBIG)前抽取股静脉血用流式细胞仪检测T淋巴细胞亚群,采用酶联免疫法(ELISA)检测乙型肝炎病毒标志物(HBVm)定量。1个月龄时复查HBVm并根据HBsAg情况分为宫内感染组和非宫内感染组。比较两组婴儿血清中T淋巴细胞亚群CD3+、CD4+、CD8+的绝对计数和百分数。结果宫内感染组新生儿CD4+绝对计数和百分数均低于未感染组,而CD8+绝对计数和百分数均高于未感染组,CD4+/CD8+比值低于未感染组,两组间差异均有显著意义,P<0·05。CD3+绝对计数两组间差异无显著性意义,P>0·05。结论宫内感染HBV新生儿可能存在T淋巴细胞亚群比例失调,有可能通过增强特异性免疫反应而得到治疗。
Objective To investigate the mechanism of immune failure in intrauterine infection by detecting the T lymphocyte subpopulation in neonates with intrauterine infection of hepatitis B virus (HBV) and provide a theoretical basis for future immunization intervention. Methods A total of 90 newborns with HBsAg positive pregnant women delivered from the Second Hospital of Nanjing, Southeast University from March 2003 to July 2003 were enrolled in this study. The maternal and infant co-immunization was performed. The femoral vein was extracted before the injection of hepatitis B immunoglobulin (HBIG) Blood T-lymphocyte subsets were detected by flow cytometry, and quantitative analysis of hepatitis B virus (HBV) markers was performed by enzyme-linked immunosorbent assay (ELISA). At 1 month of age, HBVm was reexamined and divided into intrauterine infection group and non-intrauterine infection group according to the HBsAg condition. The absolute counts and percentages of CD3 +, CD4 +, and CD8 + of T lymphocyte subsets in two groups of infants were compared. Results The absolute counts and percentages of CD4 + in neonates with intrauterine infection were lower than those in non-infected patients, but the absolute counts and percentages of CD8 + were higher than those in non-infected patients and the ratios of CD4 + / CD8 + were lower than those in non-infected patients , P <0 · 05. There was no significant difference between the two groups in absolute CD3 + counts (P> 0.05). Conclusion Intrauterine infection of HBV newborn may exist T lymphocyte subsets imbalance, may be enhanced by specific immune response and treatment.