不孕症乙肝病毒携带者接受体外受精治疗的安全性探讨  

Explore the security in HBV carried infertility patients during the in-vitro-fertilization procedure

作　　者：张红[1,2] 张顺吉[1,2] 卢光琇[1,2] 

机构地区：[1]中南大学生殖与干细胞工程研究所,湖南长沙410008 [2]中信湘雅生殖与遗传专科医院

出　　处：《中国医师杂志》2009年第6期745-747,共3页Journal of Chinese Physician

摘　　要：目的探讨不孕症乙肝病毒携带者接受体外受精治疗的安全性。方法对149例女性不孕症乙肝病毒携带者及144例男性乙肝病毒携带者采用酶联免疫方法（ELISA），于取卵日分别检测患者的血液、卵泡液、受精培养液、精液、洗涤后精液的HBV血清学五项标志物的阳性率，按HBV血清学五项标志物将男女HBV携带者分为HBV大三阳和小三阳组，分析其卵泡液及受精培养液；精液和洗涤后精液HBV的阳性率。结果18例女性血液HBV大三阳者，卵泡液、受精培养液中检测HBV大三阳均为100．0％；131例女性血液HBV小三阳者，其中，64．1％（84／131）的卵泡液及6．1％（8／131）受精培养液为小三阳；23例男性血液HBV大三阳者精液及洗涤后HBV检测大三阳阳性率为26．1％（6／23），洗涤后精液HBV检测均为阴性；121例男性血液HBV小三阳者，精液HBV检测小三阳阳性率为5．8％（7／121），洗涤后精液HBV检测均为阴性。结论体外受精处理不能改变女性乙肝大三阳患者的通过卵泡液及受精培养液传播HBV的风险，可降低女性乙肝小三阳患者和男性HBV患者的传播风险。Objective To study the security in HBV carried infertility patients during the in-vitro-fertilization procedure. Methods Serologic testing of HBV infection （ HBsAg, HBsAb, HBeAg, anti-HBe, anti-HBe-IgG） of blood, follicle fluid/sperm and fertilization culture medium/post-washing sperm in female/male carried patients were detected by ELISA on the day of oocytes collection. Results In 18 female patients who were seropositive for HBsAg, HBeAg and anti-HBc-IgG, the same antigen and antibody could be detected in all 18 folliele-fluid and fertilization culture medium（ 100% , 100% ）. In 131 female patients who were seropositive for HBsAg, anti-HBe, anti-HBc- IgG, the same antigen and antibody could be detected in 84 follicle-fluid（64. 1% ） , and 8 fertilization culture medium（6. 1% ）. If the patients＇folliele-fluid was negative for all the markers, their fertilization culture medium remained negative. In 23 male patients who were seropositive for HBsAg , HBeAg,and anti-HBc-IgC, the same antigen and antibody could be detected in only 6 sperm （26. 1% ） , all the postwashing sperm were exhibited negative. In 121 male patients who were seropositive for HBsAg, anti-HBe, anti-HBc-IgG, the same antigen and antibody could be detected in only 7 sperm （5.8%）, and all the post-washing sperm were negative. Conclusion In IVF-ET procedures, the risk of HBV transmission by follicle-fluid and fertilization culture medium in those female patients who showed seropositive for HB- sAg , HBeAg, and anti-HBc-IgG can not be decreased. The risk in those female patients who showed seropositive for HBsAg, anti-HBe, anti-HBc-IgG and male patients in IVF-ET procedures can be decreased.

关 键 词：不育 女(雌)性/治疗 肝炎 乙型/治疗 授精 人工 

分 类 号：R7[医药卫生—临床医学] R51