丙型肝炎母子垂直传播的危险因素及其预后的研究  

Vertical transmission of hepatitis C virus: risk factors and infantile prognosis

作　　者：熊曙康[1] 郑明男[2] 张振强[1] 邵小光[1] 

机构地区：[1]大连市妇产医院生殖健康保健中心,116021 [2]大连市中心医院妇产科

出　　处：《中国妇产科临床杂志》2004年第3期194-196,共3页Chinese Journal of Clinical Obstetrics and Gynecology

摘　　要：目的　研究丙型肝炎病毒 (hepatitisCvirus,HCV)母婴垂直传播发生率、危险因素及其携带者婴儿的预后。方法　筛查健康孕妇的HCV抗体。采用逆转录多肽酶链反应法 (thereversetranscriptionpolymerasechainreaction ,RT -PCR)检测抗体阳性孕妇的血液HCV -RNA。监测并追踪调查携带者孕妇及其分娩的婴儿情况。χ2 检验分析其差异的显著性。结果　 1 94 1例孕妇中 ,HCV抗体阳性率为 3 7% ;HCV -RNA阳性率为3 5 %。在监测期间 6 0 %的携带者孕妇出现血清丙氨酸转氨酶 (alanineaminotransferase,ALT)水平的升高 (ALT≥6 0IU L)。HCV母婴垂直传播率为 6 2 %。分娩前血清ALT≥ 1 1 0IU L的孕妇所分娩的 5例新生儿中 ,3例 (6 0 % )成为HCV携带者 ;而由血清ALT <1 1 0IU L孕妇分娩的 6 0例新生儿中 ,仅有 1例 (1 7% )成为HCV携带者 (P<0 0 0 5 )。 2 7例接受 1～ 6个月母乳喂养的新生儿中 ,没有出现HCV携带者的病例。结论　HCV可以发生母婴垂直传播 ,但是传播率比乙型肝炎病毒 (hepatitisBvirus ,HBV)要低得多 ,垂直传播并不是HCV感染的重要途径。围产期孕母血清ALT水平升高超过 1 1 0IU L是HCV垂直传播的临界值。Objective To clarify the incidence and risk factors of the vertical transmission of hepatitis C virus (HCV) and to explore the prognosis of the carrier infants. Methods A total of 1941 healthy (non-HIV carriers) pregnant women were screened for anti-HCV antibodies. HCV-RNA in the serum of the antibody-positive women was examined by the reverse transcription polymerase chain reaction (RT-PCR). The carrier women and their infants were followed up by testing HCV-related makers. Results The HCV carrier rate among the pregnant women was 3 5% (68/1941). Four among the 65 infants (6 2%) who were successfully followed up for more than 6 months became HCV carrier. Among all of the risk factors examined, only the elevation of maternal serum alanine aminotransferase (ALT≥110 IU/L) was found to be related to HCV vertical transmission. None of the 27 babies, who were raised by breast feedings, became HCV carrier. Conclusions The incidence of HCV vertical transmission is 6 2%. HCV vertical transmission is significantly associated with the maternal serum ALT level prior to delivery and is not affected by breast feedings.

关 键 词：丙型肝炎 母子垂直传播 危险因素 预后 

分 类 号：R714.25[医药卫生—妇产科学]