中华全科医师杂志
中華全科醫師雜誌
중화전과의사잡지
CHINESE JOURNAL OF GENERAL PRACTITIONERS
2015年
1期
33-36
,共4页
居红芳%徐洪涛%沈美龙%许仕敏%吴俊华
居紅芳%徐洪濤%瀋美龍%許仕敏%吳俊華
거홍방%서홍도%침미룡%허사민%오준화
妊娠初期%肝炎e抗原,乙型%肝炎病毒,乙型%DNA,HBV%自然杀伤细胞
妊娠初期%肝炎e抗原,乙型%肝炎病毒,乙型%DNA,HBV%自然殺傷細胞
임신초기%간염e항원,을형%간염병독,을형%DNA,HBV%자연살상세포
Pregnancy trimester,first%Hapatitis B e antigens%Hepatitis B virus%HBV DNA%Natural killer cells
目的 了解HBeAg阳性孕妇妊娠早期HBV复制受到抑制后的HBeAg滴度与自然杀伤(NK)细胞水平变化.方法 回顾性分析泰州市人民医院2010年9月至2013年4月收治的54例HBeAg阳性孕妇的临床资料,其中妊娠12周时HBV DNA下降2 log以上者24例为免疫激活组,HBV DNA无下降者30例为免疫耐受组,比较两组患者的ALT、总胆红素、HBsAg和HBeAg滴度、HBV DNA定量及NK细胞百分比及绝对值水平.结果 妊娠12周时免疫激活组ALT水平(146.7±93.1)U/L,并有12例(50％)血ALT水平升高,与免疫耐受组ALT水平[(44.1±14.7)U/L]、ALT异常例数(2例)及比例(7％)相比明显升高(t=2.95,x2=4.97,均P＜0.05).两组HBeAg滴度妊娠前分别为(467.4±226.6)与(451.5±274.0) S/CO,差异无统计学意义,妊娠12周时免疫激活组HBeAg滴度下降至(291.8±170.5)S/CO,免疫耐受组为(443.7±289.9)S/CO,两者比较差异有统计学意义(t =2.81,P＜0.05).而NK细胞绝对数及百分比免疫激活组和免疫耐受组依次为(370.9±136.4)/μl、(26.7±9.1)％及(213.2 ±97.8)/μl、(17.1±7.8)％,NK细胞在免疫激活组中活化明显(t值分别为2.38和2.52,均P＜0.05).结论 妊娠早期部分乙肝携带者孕妇可能通过NK细胞途径达到抑制病毒复制作用.
目的 瞭解HBeAg暘性孕婦妊娠早期HBV複製受到抑製後的HBeAg滴度與自然殺傷(NK)細胞水平變化.方法 迴顧性分析泰州市人民醫院2010年9月至2013年4月收治的54例HBeAg暘性孕婦的臨床資料,其中妊娠12週時HBV DNA下降2 log以上者24例為免疫激活組,HBV DNA無下降者30例為免疫耐受組,比較兩組患者的ALT、總膽紅素、HBsAg和HBeAg滴度、HBV DNA定量及NK細胞百分比及絕對值水平.結果 妊娠12週時免疫激活組ALT水平(146.7±93.1)U/L,併有12例(50％)血ALT水平升高,與免疫耐受組ALT水平[(44.1±14.7)U/L]、ALT異常例數(2例)及比例(7％)相比明顯升高(t=2.95,x2=4.97,均P＜0.05).兩組HBeAg滴度妊娠前分彆為(467.4±226.6)與(451.5±274.0) S/CO,差異無統計學意義,妊娠12週時免疫激活組HBeAg滴度下降至(291.8±170.5)S/CO,免疫耐受組為(443.7±289.9)S/CO,兩者比較差異有統計學意義(t =2.81,P＜0.05).而NK細胞絕對數及百分比免疫激活組和免疫耐受組依次為(370.9±136.4)/μl、(26.7±9.1)％及(213.2 ±97.8)/μl、(17.1±7.8)％,NK細胞在免疫激活組中活化明顯(t值分彆為2.38和2.52,均P＜0.05).結論 妊娠早期部分乙肝攜帶者孕婦可能通過NK細胞途徑達到抑製病毒複製作用.
목적 료해HBeAg양성잉부임신조기HBV복제수도억제후적HBeAg적도여자연살상(NK)세포수평변화.방법 회고성분석태주시인민의원2010년9월지2013년4월수치적54례HBeAg양성잉부적림상자료,기중임신12주시HBV DNA하강2 log이상자24례위면역격활조,HBV DNA무하강자30례위면역내수조,비교량조환자적ALT、총담홍소、HBsAg화HBeAg적도、HBV DNA정량급NK세포백분비급절대치수평.결과 임신12주시면역격활조ALT수평(146.7±93.1)U/L,병유12례(50％)혈ALT수평승고,여면역내수조ALT수평[(44.1±14.7)U/L]、ALT이상례수(2례)급비례(7％)상비명현승고(t=2.95,x2=4.97,균P＜0.05).량조HBeAg적도임신전분별위(467.4±226.6)여(451.5±274.0) S/CO,차이무통계학의의,임신12주시면역격활조HBeAg적도하강지(291.8±170.5)S/CO,면역내수조위(443.7±289.9)S/CO,량자비교차이유통계학의의(t =2.81,P＜0.05).이NK세포절대수급백분비면역격활조화면역내수조의차위(370.9±136.4)/μl、(26.7±9.1)％급(213.2 ±97.8)/μl、(17.1±7.8)％,NK세포재면역격활조중활화명현(t치분별위2.38화2.52,균P＜0.05).결론 임신조기부분을간휴대자잉부가능통과NK세포도경체도억제병독복제작용.
Objective To investigate serum NK cell levels in HBeAg positive early pregnancy women with immune activation.Methods Fifty four HBeAg positive pregnant women admitted in Taizhou People's Hospital from September 2010 to April 2013 were enrolled in the study.Among them,the serum HBV DNA load decreased ≥2 log at 12 weeks after pregnancy in 24 cases (immune activation group) and HBV DNA did not decrease in 30 cases (immune tolerance group).The serum level of alanine aminotransferase (ALT),total bilirubin,HBeAg,HBV DNA load and NK cells were measured.Results At week 12 of gestation,the mean ALT levels and ALT abnormality rate in immune active group were higher than those in immune tolerance group [(146.7 ±93.1) vs.(44.1 ± 14.7) U/L,t =2.95,P＜0.05,50.0％ vs.6.7％,x2 =4.97,P ＜0.05].There was no significant difference of HBeAg level between two groups before pregnancy,while HBeAg level in immune activation group was lower than that in immune tolerance group at week 12 week of gestation [(291.8 ± 170.5) vs.(443.7 ± 289.9) S/CO,t =2.81,P ＜0.05].The percentage and absolute number of NK cells in immune activation group were higher than those in immune tolerance group [(26.7 ±9.1)％ vs.(17.1 ±7.8)％,t =2.52,P ＜0.05 and (370.9 ±136.4)/μl vs.(213.2 ±97.8)/μl,t =2.38,P ＜0.05,respectively].Conclusions In HBeAg positive early pregnant women with immune activation,the inhibition of HBV DNA might be associated with the activation of NK cells.
