足月新生儿母源性抗-HBs及其亚型的特性  

Transplacentally acquired antibodies against hepatitis B surface antigen in full term infants

作　　者：武巧珍[1] 胡娅莉[2] 周乙华[2] 王志群[2] 陈建琴[2] 叶晓东[2] 蒋红[2] 

机构地区：[1]东南大学临床医学院妇产科学,南京210009 [2]南京大学附属鼓楼医院

出　　处：《中华围产医学杂志》2008年第5期292-295,共4页Chinese Journal of Perinatal Medicine

基　　金：江苏省医学重点学科--南京市鼓楼医院母-胎医学中心建设经费;江苏省医学重点人才项目（RC2007005）基金;南京市医学科技发展项目（ZKM06050）基金

摘　　要：目的分析了解足月新生儿母源性乙型肝炎表面抗体（抗-HBs）及其亚型的特性。方法2006年12月至2007年02月在南京大学附属鼓楼医院住院分娩的单胎足月孕妇及其新生儿为研究对象，AxSYM全自动免疫分析仪定量检测63例抗-HBs阳性的单胎足月孕妇及其新生儿脐血婴儿和1月龄时的血清抗-HBs浓度，用固相酶联免疫法检测孕妇和脐血中抗-HBs4种IgG亚型的含量，及其中和乙型肝炎患者血清中HBsAg的能力。结果63例抗-HBs阳性孕妇分娩的新生儿脐血抗-HBs均为阳性，几何平均浓度为195．4mIU／ml，明显高于孕妇平均水平141．6mIU／ml（P〈O．01）。脐血抗-HBs浓度与母体水平高度相关（rs=0．976，P〈0．01）。无论是接种还是自然感染获得的抗-HBs，其4种kG亚型均可通过胎盘，均以IgGl为主。1月龄婴儿抗-HBs平均浓度是脐血的64％，推测被动获得的抗-HBs衰减半衰期约41d。脐血抗-HBs可中和乙型肝炎患者血清中HBsAg，其中和作用与抗-HBs浓度有关。结论kG型抗-HBs及其四种亚型均可通过胎盘，以IgGl为主。母源性抗-HBs可保护新生儿免受HBV感染。Objective To analyze the correlation of the concentration of antibodies against hepatitis B surface antigen （anti-HBs） between normal full term pregnant women and their newborns. Methods Sixty-three paired serum samples from infants and their anti-HBs positive mothers, who delivered in the Affiliated Drum Tower Hospital of Nanjing Medical University School from Dec. 2006 to Feb. 2007, were quantitatively tested for anti-HBs by AxSYM AUSAB immunoassay. Subclasses of anti-HBs IgG were analyzed. The neutralizing activity of maternal anti-HBs in infants was assessed by surrogate assay. Results All infants born to anti-HBs positive mothers were also seropositive. Anti-HBs levels in infants were correlated with the maternal concentration（rs=0. 976, P〈0. 01）, and majority of the infants had higher concentrations than their mothers（195.4 mIU/ml vs 141.6 mIU/ ml, P%0.01）. The mean half-life of maternal anti-HBs in infants was estimated to be 41 days. Anti HBs IgGl subclass was predominantly in infants, which was in agreement with that in their mothers. Transplaeentally transferred anti-HBs in infants efficiently bound the hepatitis B surface antigen derived from hepatitis B patients. Conclusions Anti-HBs IgG can efficiently transfer through the placenta. Infants born to anti HBs positive mothers may be immune to hepatitis B virus in the early life of several months.

关 键 词：肝炎表面抗原 乙型 免疫球蛋白G 婴儿 新生 

分 类 号：R714[医药卫生—妇产科学]