河北地区新生儿脐血T细胞亚群与HBV宫内感染的相关性研究

发布时间：2018-07-08 10:09

本文选题：慢性乙型肝炎病毒 + 宫内感染　；参考：《河北医科大学》2017年硕士论文

【摘要】：目的:采集新生儿的脐血进行细胞免疫学检测,探讨河北地区HBV宫内感染新生儿脐血T淋巴细胞亚群的特点,分析T淋巴细胞亚群与新生儿免疫状态的关系,并对新生儿宫内感染的影响因素及其对新生儿免疫功能的影响进行进一步探索,为河北地区新生儿HBV宫内感染的早期诊断、预防和临床治疗提供新思路,并为临床诊治新生儿罹患感染性疾病提供具有潜在意义的指标。方法:选择河北医科大学第一医院及石家庄市第五医院2016年5月至2016年12月河北地区汉族孕产妇分娩的新生儿45例。研究对象分为病例组[HBV表面抗原阳性(HBsAg)孕妇分娩新生儿]36例,其中包括宫内感染组7例和宫内未感染组29例,并选择同期正常孕妇分娩新生儿9例为对照组。所有孕妇均采集外周血并采用酶联免疫吸附法(ELISA)测定乙型肝炎病毒标志物(乙肝五项)指标,新生儿脐血送合作单位河北医科大学动物实验中心均测乙肝五项和HBV-DNA,并采用流式细胞术检测T细胞亚群。分析三组脐血T淋巴细胞亚群的百分比。结果:1本次分析的45例新生儿中,感染组、未感染组、对照组分别为7例、29例、9例。其宫内感染组(共7例)中1例HBV-DNA为阳性,5例HBsAg均为阳性,1例HBsAg和HBV-DNA均为阳性,孕产妇HBV宫内感染率为15.56%(7/45)。2在感染组、未感染组、对照组三组中,CD19+、NK细胞阳性率在三组间的差异均无统计学意义(H=3.59、0.80,P均0.05);CD3、CD4、CD8以及CD4/CD8,感染组与未感染组,感染组与对照组三组间差异均有统计学意义,而未感染组与对照组间差异无统计学意义。其中CD3+表达(%)分别为(59.71±7.18)、(70.83±11.40)、(77.87±9.50),三组间差异均有统计学意义(F=5.83,P=0.006),两两比较后,CD3+阳性率,感染组明显低于未感染组及对照组,差异均有统计学意义(P0.05);3组CD4+表达(%)分别为40.90(36.20,42.10)、53.30(44.45,58.25)、50.50(45.20,56.95),感染组明显低于未感染组及对照组,三组间差异均有统计学意义(F=9.14,P=0.01),两两比较后,CD4+阳性率,感染组明显低于未感染组及对照组,差异均有统计学意义(P0.05);3组CD8+表达(%)分别为29.50(26.00,33.10)、18.40(14.20,24.35)、24.80(18.20,27.30),感染组明显高于未感染组及对照组,组间差异比较均存在显著性(F=9.25,P0.05);3组CD4+/CD8+比值分别为1.38(1.23,1.61)、2.75(2.07,3.47)、2.22(1.85,2.82),感染组明显低于未感染组及对照组,三组间差异均有统计学意义(F=11.32,P=0.003),两两比较后,CD4+/CD8+比值,感染组明显低于未感染组及对照组,差异均有统计学意义(P0.05)。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,T淋巴细胞亚群水平较低,提示机体感染后细胞免疫功能减低。
[Abstract]:Objective: to investigate the characteristics of T lymphocyte subsets in umbilical cord blood of newborns with HBV intrauterine infection in Hebei, and to analyze the relationship between T lymphocyte subsets and the immune status of newborns. The influencing factors of intrauterine infection of newborn and its influence on neonatal immune function were further explored in order to provide new ideas for early diagnosis, prevention and clinical treatment of HBV intrauterine infection in newborns in Hebei province. It also provides a potential index for clinical diagnosis and treatment of neonatal infectious diseases. Methods: 45 newborns were selected from the first Hospital of Hebei Medical University and the Fifth Hospital of Shijiazhuang City from May 2016 to December 2016. The subjects were divided into three groups: 36 cases of newborns delivered by HBsAg positive pregnant women, including 7 cases of intrauterine infection group and 29 cases of intrauterine uninfected group, and 9 cases of normal pregnant women giving birth as control group. Peripheral blood samples were collected from all pregnant women and the markers of hepatitis B virus (HBV) were determined by enzyme linked immunosorbent assay (Elisa). Five items of hepatitis B and HBV-DNA were measured in the animal experimental center of Hebei Medical University, and T cell subsets were detected by flow cytometry. The percentage of T lymphocyte subsets in umbilical cord blood was analyzed. Results among 45 newborns in this analysis, 7 cases were infected, 9 cases were uninfected, and 9 cases were control group. In the intrauterine infection group (7 cases), 1 case was positive for HBV-DNA, 5 cases were positive for HBsAg and 1 case was positive for HBsAg and HBV-DNA. The intrauterine infection rate of HBV in pregnant women was 15.56% (7 / 45) in infected group and non-infected group. There was no significant difference in the positive rate of CD19 + NK cells between the three control groups (P 0.05). The positive rates of CD3 + CD4 / CD8 and CD4 / CD8 were significantly different between the infected group and the uninfected group, and between the infected group and the control group. There was no significant difference between the uninfected group and the control group. The expression of CD3 was (59.71 卤7.18), (, 70.83 卤11.40), (, 77.87 卤9.50), and the difference among the three groups was statistically significant (F5. 83, P0. 006). The positive rate of CD3 in the infected group was significantly lower than that in the uninfected group and the control group. The expression of CD4 in the three groups was 40.90 (36.2042.10), 53.30 (44.45.58.25) and 50.50 (45.2056.95) respectively. The positive rate of CD4 was significantly lower in the infected group than in the uninfected group and the control group (F9.14Pn0.01). The positive rate of CD4 in the infected group was significantly lower than that in the uninfected group and the control group. There were significant differences in CD8 expression (P 0.05) between the three groups (P 0.05). The expression of CD8 in the three groups were 29.50 (26.003.10) and 18.40 (14.204.35), 24.80 (18.200.27.30), respectively. The difference between the infected group and the non-infected group and the control group was significant (FF9.25P0.05). The CD4 / CD8 ratio of the 3 groups was 1.38 (1.231.61) / 2.75 (2.073.47) 2.22 (1.852.82), respectively, which was significantly lower than that of the uninfected group and the control group. There were significant differences among the three groups (F _ (11.32) P _ (0. 003). The ratio of CD _ 4 / CD _ 8 in the infection group was significantly lower than that in the non-infection group and the control group (P0.05). Conclusion: the level of T lymphocyte subsets may be low in intrauterine HBV neonates, suggesting that the cellular immune function is decreased after infection.
【学位授予单位】：河北医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R722.1

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