Research Of The Relationship Between Umbilical Cord Blood Cytokine IFN-?,IL-4,Immunoglobulin And HBV Intrauterine Infection In Neonates

Objective: To investigate the relationship between the levels of cytokines(IFN-?,IL-4,IFN-?/IL-4),immunoglobulin(IgA,IgG,Ig M),complement(C3,C4)and HBV intrauterine infection in neonatal umbilical cord blood,and to understand the effects of different modes of delivery on neonatal immune status.This paper presents a new idea for early prevention and treatment of neonatal HBV intrauterine infection,provides a basis for the clinical diagnosis and treatment of neonatal infectious diseases,improving neonatal immune status.Methods: A total of 118 neonates from June 2016 to December 2017 for maternal childbirth were selected in our hospital and cooperative hospital.75 cases were divided into case group [HBV surface antigen positive(HBsAg)pregnant women in childbirth],including intrauterine infection group(17cases)and intrauterine uninfected group(58 cases).43 newborns with normal pregnant women in the same period were selected as control group.And according to different delivery methods,these 118 cases were divided into vaginal delivery group(75 cases)and cesarean section group(43 cases).All neonatal umbilical cord blood was tested for hepatitis B virus markers and HBV-DNA.The levels of IFN-? and IL-4 were detected by ELISA,and the contents of immunoglobulin and C3,C4 were determined by the method of immune turbidimetric assay,and statistical analysis was carried out.Results:1.Among the 118 newborns enrolled in the study,intrauterine infection group,uninfected group and control group were 17 cases,58 cases and 43 cases.In the intrauterine infection group,5 cases of HBV-DNA were positive,11 cases were positive for HBsAg and 1 case of HBsAg and HBV-DNA were positive.2.The level of IFN-?,the ratio of IFN-?/IL-4 and the level of complement C3 in infected group were lower than that in the uninfected group and the control group(P<0.01).The level of IL-4,IgA and Ig M in infection group was higher than that of uninfected group and control group,and the difference was statistically significant(P<0.01).There was no statistically significant difference in IFN-? level,IL-4 level,IFN-?/IL-4 ratio,Ig A?IgM and C3 in the uninfected group compared with the control group(P>0.05).There was no statistically significant difference between Ig G and complement C4 levels in the intrauterine infection group,uninfected group,control group(P>0.05).3.The values of IgG,IgM and C3 and C4 in umbilical cord blood were higher than that of cesarean section in neonates with vaginal delivery,and the difference was statistically significant(P<0.05).Conclusions:1.Cellular immune dysfunction in neonates with HBV intrauterine infection weakens the secretion IFN-? of Th1-type cells,elevates the content IL-4 in Th2-type cells,causes the imbalance of Th1/Th2 type factor,and these conditions are likely to lead to neonatal intrauterine infection.2.The increase of IgA and IgM levels in neonatal HBV intrauterine infection and the decrease of complement C3 content contribute to early detection and diagnosis of neonatal infection.3.Vaginal delivery should be advocated in clinic because the neonatal humoral immunity function of vaginal delivery is higher than that of the newborn undergoing caesarean delivery.