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.; abstract：; 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.