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目的研究孕中期乙肝孕妇血清白细胞介素IL-16、T细胞亚群、AFP的水平变化及相互关系。方法采用实时荧光PCR检测2011年1月~2014年3月73例乙肝孕妇HBV DNA并分组,A组(HBV DNA<103copies/ml),B组(103copies/ml≤HBV DNA<106copies/ml),C组(HBV DNA≥106 copies/ml)。采用酶联免疫吸附法(ELISA)检测血清IL-16;流式细胞仪测定T细胞亚群;电化学发光法检测血清AFP;并纳入30例正常孕妇作对照。结果 B、C组血清IL-16水平高于A组和对照组,差异有统计学意义(tIL-16=3.568~5.329,P均<0.05)。B组血清AFP水平高于对照组和A组,差异有统计学意义(tAFP=3.435,3.857,P均<0.05);C组血清AFP水平高于其他3组,差异有统计学意义(tAFP=1.758~5.354,P值均<0.05)。B、C组CD4+T细胞及CD4+/CD8+比值较A组和对照组减低,CD8+T细胞较A组和对照组升高,差异有统计学意义(tCD4+=2.101~3.586,tCD4+/CD8+=1.903~2.259,tCD8+=1.774~2.816,P均<0.05)。乙型肝炎孕妇组血清IL-16与AFP呈正相关(r=0.413,P<0.05)。结论乙肝孕妇血清IL-16、T细胞亚群的动态变化可提示HBV感染孕妇机体免疫功能的变化,且与AFP联合检测可减少乙型肝炎对孕妇产前筛查结果的影响。
Objective To study the changes of interleukin-16 (IL-16), T cell subsets and AFP in pregnant women with second trimester of pregnancy and their correlations. Methods HBV DNA was detected in 73 pregnant women with hepatitis B from January 2011 to March 2014 by real-time fluorescence PCR. Group A (HBV DNA <103 copies / ml), group B (103 copies / ml ≤ HBV DNA <106 copies / ml) Group C (HBV DNA ≥ 106 copies / ml). Serum IL-16 was detected by enzyme-linked immunosorbent assay (ELISA); T cell subsets were determined by flow cytometry; serum AFP was detected by electrochemiluminescence assay and 30 normal pregnant women were included as control. Results The levels of serum IL-16 in group B and group C were higher than those in group A and control group (tIL-16 = 3.568-5.329, P <0.05). The level of serum AFP in group B was higher than that in control group and group A (tAFP = 3.435, 3.857, P <0.05). The level of serum AFP in group C was higher than the other three groups (tAFP = 1.758 ~ 5.354, P <0.05). The ratio of CD4 + T cells and CD4 + / CD8 + in group B and C was lower than that in group A and control group, and the level of CD8 + T cells in group B and C was higher than that in group A and control group (tCD4 + = 2.101-3.586, tCD4 + / CD8 + 1.903 ~ 2.259, tCD8 + = 1.774 ~ 2.816, P <0.05). Serum levels of IL-16 in hepatitis B pregnant women were positively correlated with AFP (r = 0.413, P <0.05). Conclusion The dynamic changes of serum IL-16 and T cell subsets in pregnant women with HBV may indicate the changes of immune function in pregnant women with HBV infection. Combined detection with AFP may reduce the influence of hepatitis B on the prenatal screening results in pregnant women.