HBsAg阳性母亲新生儿免疫无或弱应答影响因素
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摘要
目的分析乙型肝炎病毒表面抗原(hepatitis B surface antigen,HBsAg)阳性母亲新生儿乙肝免疫无、弱应答的影响因素。方法选取惠州市第六人民医院儿童保健科2017年6月—2018年6月追踪随访的95对HBsAg阳性母亲及新生儿作为研究对象,根据新生儿乙肝免疫应答反应分为无、弱应答组15例和强应答组80例,对两组研究对象基本资料进行比较,采用多因素Logistic回归分析总结HBsAg阳性母亲新生儿乙肝免疫无、弱应答的影响因素。结果两组新生儿母亲年龄、分娩方式、分娩史、喂养方式差异无统计学意义(P>0.05),母亲HBV-DNA载量、免疫细胞数量、外周血单个核细胞Toll样受体3蛋白平均荧光强度差异有统计学意义(P<0.05)。多因素Logistic回归分析提示,母亲HBV-DNA高载量、高外周血单个核细胞Toll样受体3蛋白平均荧光强度为HBsAg阳性母亲新生儿乙肝免疫无、弱应答的独立影响因素(P<0.05)。结论母亲HBV-DNA高载量、高外周血单个核细胞Toll样受体3蛋白平均荧光强度为HBsAg阳性母亲新生儿乙肝免疫无、弱应答的独立影响因素,应引起临床的高度重视。
Objective To analyze the influencing factors of immune deficiency and weak response in neonates with hepatitis B surface antigen(HBsAg) positive mothers. Methods Totally 95 pairs of HBsAg positive mothers and newborns and who followed up in Department of Child Health of the Sixth People's Hospital of Huizhou City from June 2017 to June 2018 were selected as the research objects, and divided into 15 cases in the deficiency and weak response group and 80 cases in strong response group according to neonatal hepatitis B immune response.Then,the basic data of two groups were compared,and the influencing factors of immune deficiency and weak response in neonates with HBsAg positive mothers were summarized by the multivariate Logistic regression analysis.Results There was no significant difference in maternal age, delivery mode,delivery history and feeding pattern in newborn between the two groups(P>0.05), and there was significant differences in maternal HBV-DNA load, number of immune cells and average fluorescence intensity of Toll-like receptor 3 protein in peripheral blood mononuclear cells(P < 0.05).The multivariate logistic regression analysis showed that the high maternal HBVDNA load and high average fluorescence intensity of Toll-like receptor 3 protein in peripheral blood mononuclear cells were independent factors for immune deficiency and weak response in neonates with HBsAg positive mothers(P<0.05).Conclusion The high maternal HBV-DNA load and high average fluorescence intensity of Toll-like receptor 3 protein in peripheral blood mononuclear cells are the independent influencing factors for hepatitis B immune deficiency and weak response in neonates with HBsAg positive mothers,which it should be paid more attention in clinical.
Objective To analyze the influencing factors of immune deficiency and weak response in neonates with hepatitis B surface antigen(HBsAg) positive mothers. Methods Totally 95 pairs of HBsAg positive mothers and newborns and who followed up in Department of Child Health of the Sixth People's Hospital of Huizhou City from June 2017 to June 2018 were selected as the research objects, and divided into 15 cases in the deficiency and weak response group and 80 cases in strong response group according to neonatal hepatitis B immune response.Then,the basic data of two groups were compared,and the influencing factors of immune deficiency and weak response in neonates with HBsAg positive mothers were summarized by the multivariate Logistic regression analysis.Results There was no significant difference in maternal age, delivery mode,delivery history and feeding pattern in newborn between the two groups(P>0.05), and there was significant differences in maternal HBV-DNA load, number of immune cells and average fluorescence intensity of Toll-like receptor 3 protein in peripheral blood mononuclear cells(P < 0.05).The multivariate logistic regression analysis showed that the high maternal HBVDNA load and high average fluorescence intensity of Toll-like receptor 3 protein in peripheral blood mononuclear cells were independent factors for immune deficiency and weak response in neonates with HBsAg positive mothers(P<0.05).Conclusion The high maternal HBV-DNA load and high average fluorescence intensity of Toll-like receptor 3 protein in peripheral blood mononuclear cells are the independent influencing factors for hepatitis B immune deficiency and weak response in neonates with HBsAg positive mothers,which it should be paid more attention in clinical.
引文
[1]沈国红,管长丽,韩启军,等.先天性人巨细胞病毒感染肝功能与乙肝疫苗免疫应答的相互影响[J].预防医学论坛,2016,22(1):54-57.
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[4]杨淑琪.新生儿接种乙肝疫苗效果评价及低、无应答者再免疫效果的预防分析[J].中国社区医师,2018,34(16):169,171.
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[7]李美芳,王洪鹏,王永洁,等.新生儿乙型肝炎疫苗初免及加强免疫应答与出生体重的相关性观察[J].实用预防医学,2016,23(6):641-642.
[8]余祖卫,李玉莲,陈丽华,等.cTfh细胞及相关miR-146a在乙肝疫苗记忆性免疫应答中的动态表达及关联研究[J].中国当代医药,2018,25(20):12-15.
[9]郭山春,康丽娟,李宝强,等.母体血清抗-HBs水平对婴儿乙肝疫苗接种免疫应答的影响[J].实用预防医学,2017,24(4):390-393.
[10]KLINGER G,CHODICK G,LEVY I.Long-term immunity to hepatitis B following vaccination in infancy:Real-world data analysis[J].Vaccine,2018,36(17):2288-2292.
[11]庞琳,王彩英,何明,等.HBsAg阳性母亲其婴幼儿免疫阻断后无/低应答危险因素及个体化免疫干预效果分析[J].中华实验和临床感染病杂志(电子版),2017,11(5):508-512.
[12]王明,边茜,朱云霞.HBsAg阳性产妇分娩婴儿乙肝免疫接种低和无应答的影响因素[J].北京医学,2016,38(12):1279-1281.
[13]MAINI M K,PALLETT L J.Defective T-cell immunity in hepatitis B virus infection:why therapeutic vaccination needs a helping hand[J].Lancet Gastroenterol Hepatol,2018,3(3):192-202.
[14]彭静媛,黄蓉.乙肝疫苗联合乙肝免疫球蛋白阻断乙肝病毒母婴传播的临床效果[J].湖南师范大学学报(医学版),2016,13(3):103-105.
[15]陈桂珍,江丽君.婴幼儿接受通用高剂量的乙肝疫苗后的免疫应答:在北京以社区为基础的研究[J].微生物学免疫学进展,2017,45(1):17.2018-09-11
[2]杨锋,陈雅琴,林秋兰,等.HBsAg阳性母亲婴儿乙肝疫苗应答反应的相关因素分析[J].中国妇幼健康研究,2018,29(3):379-381.
[3]陈奋,林道炯.母亲血清抗-HBs阳性对其新生儿接种乙肝疫苗接种效果的影响研究[J].实用肝脏病杂志,2018,21(4):557-560.
[4]杨淑琪.新生儿接种乙肝疫苗效果评价及低、无应答者再免疫效果的预防分析[J].中国社区医师,2018,34(16):169,171.
[5]CORTI D,BENIGNI F,SHOUVAL D.Viral envelope-specific antibodies in chronic hepatitis B virus infection[J].Current Opinion in Virology,2018,30:48-57.
[6]陈霞,王玉平.HBsAg阳性母亲新生儿乙肝疫苗应答的影响因素研究[J].中国妇幼健康研究,2018,29(8):958-961.
[7]李美芳,王洪鹏,王永洁,等.新生儿乙型肝炎疫苗初免及加强免疫应答与出生体重的相关性观察[J].实用预防医学,2016,23(6):641-642.
[8]余祖卫,李玉莲,陈丽华,等.cTfh细胞及相关miR-146a在乙肝疫苗记忆性免疫应答中的动态表达及关联研究[J].中国当代医药,2018,25(20):12-15.
[9]郭山春,康丽娟,李宝强,等.母体血清抗-HBs水平对婴儿乙肝疫苗接种免疫应答的影响[J].实用预防医学,2017,24(4):390-393.
[10]KLINGER G,CHODICK G,LEVY I.Long-term immunity to hepatitis B following vaccination in infancy:Real-world data analysis[J].Vaccine,2018,36(17):2288-2292.
[11]庞琳,王彩英,何明,等.HBsAg阳性母亲其婴幼儿免疫阻断后无/低应答危险因素及个体化免疫干预效果分析[J].中华实验和临床感染病杂志(电子版),2017,11(5):508-512.
[12]王明,边茜,朱云霞.HBsAg阳性产妇分娩婴儿乙肝免疫接种低和无应答的影响因素[J].北京医学,2016,38(12):1279-1281.
[13]MAINI M K,PALLETT L J.Defective T-cell immunity in hepatitis B virus infection:why therapeutic vaccination needs a helping hand[J].Lancet Gastroenterol Hepatol,2018,3(3):192-202.
[14]彭静媛,黄蓉.乙肝疫苗联合乙肝免疫球蛋白阻断乙肝病毒母婴传播的临床效果[J].湖南师范大学学报(医学版),2016,13(3):103-105.
[15]陈桂珍,江丽君.婴幼儿接受通用高剂量的乙肝疫苗后的免疫应答:在北京以社区为基础的研究[J].微生物学免疫学进展,2017,45(1):17.2018-09-11