孕妇血清中乙型肝炎病毒复制水平与胎儿宫内感染的关系  

Relationship between intrauterine infection and viral replication in pregnant women with Hepatitis B virus

作　　者：武四云[1] 郭婧婧[1] 陈远林[2] 

机构地区：[1]中南大学湘雅医学院检验系,湖南长沙410008 [2]中南大学湘雅二医院检验科,湖南长沙410011

出　　处：《中国现代医学杂志》2007年第3期360-362,364,共4页China Journal of Modern Medicine

摘　　要：目的探讨孕妇血清中乙型肝炎病毒(HBV)核心抗原(HBeAg)、前S1抗原(Pre-S1Ag)和病毒DNA(HBV-DNA)与胎儿宫内乙型肝炎病毒感染的关系。方法应用酶联免疫吸附试验(ELISA)和荧光定量聚合酶链反应(FQ-PCR)对165例乙肝表面抗原(HBsAg)阳性孕妇的母血及产后婴儿外周血的乙型肝炎血清学标志物(HBV-M)和HBV-DNA进行检测。结果165例HBsAg阳性孕妇血清中HBeAg、Pre-S1Ag和HBV-DNA的检出率分别为29.1%、31.5%和38.2%,所生婴儿外周血中HBsAg和HBV-DNA的检出率分别为7.3%(12/165)和23.6%。HBeAg、HBVPre-S1Ag和HBV-DNA阳性孕妇所生婴儿外周血HBV-DNA的检出率分别为79.2%、75.0%和66.7%,显著高于HBeAg、Pre-S1Ag和HBV-DNA阴性者的5.1%、6.2%和0.0%,(P<0.01)。孕妇血清中平均HBVDNA的含量为(7.32±1.79)(拷贝数/mL的对数),显著高于婴儿外周血HBVDNA的(5.86±1.33),(P<0.01),婴儿外周血中HBVDNA阳性率随孕妇HBVDNA含量增加而显著增加,且呈正相关(r=0.43,P<0.01)。结论孕妇血清中HBeAg、Pre-S1Ag和HBV-DNA阳性是胎儿宫内感染HBV的高危因素,胎儿宫内感染率随母血中HBV-DNA含量增加而增加。[Objective] To investigate the relationship between intrauterine infection and HBeAg, Pre-S1Ag and HBV-DNA in pregnant women with chronic Hepatitis B. [Methods] Serologic HBV marks （HBVM） and HBV-DNA in blood samples of 165 HBsAg（＋） pregnant women, peripheral blood of neonates were detected by enzyme linked immunoadsorbent assay （ELISA） and flurence quantitative polymerase chain reaction （FQ-PCR）. [Results] The positive rate of HBeAg, Pre-S1Ag and HBV-DNA in HBsAg（＋） pregnant women were 29.1%, 31.5% and 38.2%, respectively. The positive rate of HBsAg and HBV-DNA in peripheral blood of neonates were 7.3% and 23.6% respectively. When HBeAg（＋）, Pre-S1Ag（＋） and HBV- DNA（＋） in pregnant women, HBV-DNA positive rate of their infants blood was 79.2%, 75.0% and 66.7%, respectively, which was significantly higher than those with HBeAg（-）, Pre-S1Ag（-） or HBV-DNA（-） （P 〈0.01）. The average concentrations of serum HBV-DNA in 48 pregenant women was （7.32±1.79）, which was significantly higher than that of peripheral blood of neonates （5.86±1.33） （P 〈0.01）. And their HBV-DNA load was positively correlated （r=0.43, P 〈0.01）. [Conclusion] HBeAg（＋）, Pre-S1Ag（＋） or HBV- DNA（＋） in pregnant women is one of the high risk factors of fetal intrauterine infection. Intrauterine infectious rate increased significantly when HBV DNA load was increased in blood of pregnant women.

关 键 词：肝炎病毒 乙型 病毒复制 疾病传播 垂直 

分 类 号：R512.62[医药卫生—内科学]