目的 检测细胞内外IFNγ和IL-4水平,评估慢性乙型肝炎(CHB)和HBV携带患儿Th1/Th2应答状态.方法 收集2007年5月-2009年2月54例住院患儿,将其分为CHB组(23例)和HBV携带组(31例),另外选取34名健康儿童作为对照.采用ELISA法检测研究对象全血细胞外IFNγ和IL-4,采用流式细胞术检测细胞内IFNγ和IL-4.方差齐者行方差分析,不齐者行非参数Kruskal-Wallis检验分析.结果 ELISA法检测发现,IFNγ、IL-4水平和Th1/Th2比值在CHB组、HBV携带组和健康对照组间差异无统计学意义(F=0.342、0.020和0.507,P值均＞0.05).流式细胞术检测发现细胞内IFNγ水平在CHB组、HBV携带组和健康对照组分别为(7.68±4.62)、(11.71±4.36)和(13.61±6.71)μg/mL,Th1/Th2比值分别为0.96±0.30、1.67±0.76和2.11±1.12,差异有统计学意义(F=0.255和0.140,P＜0.05或＜0.01);IL-4水平在三组间的差异无统计学意义(F=0.425,P＞0.05).结论 CHB和HBV携带组患儿细胞内因子表达失衡,细胞免疫功能受到抑制.与ELISA法相比,流式细胞技术能够更加真实、准确地反映Th1和Th2的应答状态.%Objective To evaluate extracellular and intracellular IFNγ and IL-4 levels in assessing Th1/Th2 balance in children with chronic hepatitis B (CHB) and asymptomatic carriers.Methods Fiftyfour hospitalized children including 23 CHB patients and 31 asymptomatic carriers were collected from May 2007 to February 2009.Thirty-four healthy children were served as control.Serum IFNγ and IL-4 levels were measured by enzyme-linked immunosorbent assay (ELISA) and intracellular IFNγand IL-4 levels were detected by flow cytometer.Analysis of variance (for homogenous variance) and Kruskal-Wallis test (for non-homogenous variance) were performed.Results The differences on extracellular IFNγ, IL-4 and Th1/Th2 among CHB, asymptomatic carriers and control groups were not statistically significant (F=0.342, 0.020 and 0.507, P ＞ 0.05); while the intracellular IFNγlevels were (7.68 ± 4.62), (11.71 ±4.36) and (13.61 ±6.71) μg/mL, and Th1/Th2 ratios were 0.96 ±0.30, 1.67 ±0.76 and 2.11 ± 1.12in three groups respectively (F=0.255 and 0.140, P ＜ 0.05 or ＜ 0.01).The differences in intracellular IL-4 levels among three groups were not significant (F=0.425, P ＞ 0.05).Conclusions Cytokine balance is affected in CHB children and asymptomatic carriers, and flow cytometry analysis is considered as a better method in evaluating the status of Th1/Th2 balance.
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