60例孕妇HBV血清标志物水平与母婴传播的关系分析  

Relationship between serological levels of HBV makers and maternal-infant transmission in 60 HBV-infected pregnant women

作　　者：刘芬 蒋佩茹[2] 

机构地区：[1]江苏省南京市扬子医院,南京210048 [2]上海市传染病医院,上海200083

出　　处：《传染病信息》2005年第3期129-130,144,共3页Infectious Disease Information

摘　　要：目的探讨孕妇乙型肝炎病毒(HBV)血清标志物水平与母婴传播的关系。方法采取60例孕妇、脐带、新生儿血清用美国雅培试剂做 HBV 血清标志物(HBV M)包括:HBsAg、HBsAb、HBeAg、HBeAb、HBcAb 定量分析,用荧光定量 PCR 法测HBV DNA。结果 HBsAg、HBeAg、HBcAb 阳性母亲的新生儿脐血 HBV M 阳性率91.67%,新生儿血 HBV M 阳性率85%,母血HBsAg、HBeAg、HBcAb 滴度显著高于脐血、新生儿血,且母血、脐血、新生儿血 HBV M 水平依次降低;HBV DNA 阳性率也依次降低,分别为58.33%、10%、6.67%,滴度也依次降低。HBsAg、HBeAb、HBcAb 阳性母亲,HBsAg、HBcAb 阳性母亲和单项 HBsAg 阳性母亲的新生儿脐血、新生儿血 HBV M 阳性率较低。新生儿血以 HBeAg 阳性为主,滴度明显高于正常值,HBsAg 滴度仅略高于正常值。结论母婴垂直传播与母亲 HBeAg 高滴度有密切关系,与母亲 HBV DNA 阳性或阴性关系并不十分密切。检测脐血和新生儿血 HBsAg、HBVDNA 阴性并不能排除 HBV 感染,不如检测 HBsAg、HBeAg 更有意义,更经济。Objective To explore the relationship between serological levels of HBV makers （HBV M） and maternal-infant transmission. Methods After collection of blood samples from 60 HBV-infected pregnant women and their umbilical cords and infants, HBV M were detected by ELISA and HBV DNA determined by fluorescent quantitative PCR in these samples. Results The positive rate of HBV M was 91.67% in samples of umbilical blood and 85% in samples of blood from newborns whose mothers were positive for HBsAg,HBeAg and HBcAb. The serological levels of HBsAg,HBeAg and HBcAb were significantly higher in these mothers than in umbilical cords and infants. The positive rate of HBV DNA in serum of those mothers, umbilical cords and infants was 58.33%, 10% and 6.67%, respectively, and their serological levels were descending in turn, too. The serological level of HBeAg in infants were significantly higher than the normal. However, the serological level of HBsAg was just slightly higher. The positive rate of HBV DNA in serum of infants was very low. Conclusions Intrauterine infection is closely related to higher HBeAg serological levels but weakly to HBV DNA levels. The detection of HBsAg and HBeAg is better than that of HBsAg and HBV DNA in umbilical blood and infants for determination of HBV infection.

关 键 词：乙型肝炎病毒 宫内感染 垂直传播 新生儿 HBV血清标志物 母婴传播 HBSAG阳性母亲 孕妇 HBEAG阳性 HBCAB阳性 

分 类 号：R512.62[医药卫生—内科学] R511[医药卫生—临床医学]