孕妇携带乙肝病毒与胎儿宫内感染研究  

A study on relationship of carriing of hepatitis B virus of pregnant women with intrauterine infection of fetus

作　　者：张清 马健 王云霞 资捷 李欣欣 姚涛 

机构地区：[1]广东省深圳市福田区妇幼保健院内科,广东深圳518026

出　　处：《中国妇幼健康研究》2009年第5期547-549,共3页Chinese Journal of Woman and Child Health Research

基　　金：深圳市2008年科技计划资助项目（卫生医疗类）（NO200803141）

摘　　要：目的 探讨胎儿宫内感染与孕妇血清乙肝病毒标志物的携带状态、乙肝病毒DNA含量的相关性。方法 随机选择门诊产前检查乙肝表面抗原阳性的孕妇80例，并以10例正常孕妇为对照。用酶联免疫吸附试验测定法检测孕妇及其新生儿脐血血清中乙肝病毒标志物的5项指标，用荧光定量聚合酶链反应技术检测乙肝病毒DNA载量。结果 80例乙肝病毒携带孕妇新生儿脐血乙肝病毒表面抗原、乙肝病毒e抗原、乙肝病毒DNA阳性检出率分别为17.50%、25.00%、15.00%；其中44例大三阳的孕妇体内乙肝病毒DNA载量均〉103copies/mL，而31例小三阳的孕妇仅有1例体内乙肝病毒DNA载量〉103copies/mL，经比较差异有统计学意义（χ2=69.626，P〈0.001）；44例大三阳孕妇新生儿脐血乙肝病毒表面抗原、乙肝病毒e抗原、乙肝病毒DNA阳性检出率分别为31.82%、45.45%、27.27%；而31例小三阳孕妇新生儿脐血乙肝病毒表面抗原、乙肝病毒e抗原、乙肝病毒DNA阳性检出均为阴性，其乙肝病毒DNA载量均〈103copies/mL，经比较差异均有统计学意义（χ2值为12.127、19.215、10.065，均P〈0.01）。12例乙肝病毒DNA阳性的新生儿均由大三阳且乙肝病毒DNA载量〉105copies/mL孕妇所分娩。结论 孕妇携带乙肝病毒大三阳和乙肝病毒DNA高载量（〉105copies/mL）是母婴传播宫内感染的高危因素。Objective To study relationship of serum hepatitis B virus markers （HBVM） carriing status, serum hepatitis B virus DNA load of pregnant women with intrauterine fetal infection of HBV. Methods 80 HBsAg positive pregnant women who received prenatal examination were selected randomly as study group and 10 healthy pregnant women were as controls. ELISA was used to detect 5 items of HBVmHBsAg, HBsAb, HBeAg, HBeAb and HBcAb in serum of pregnant women and umbilical blood of the neonate and fluorescence quantitative PCR was used to detect HBV-DNA content of all subjects. Results The positive detectable rates of HBsAg, HBeAg and HBV-DNA in umbilical blood of the neonates born by 80 pregnant women with positive HBsAg were 17.50% （14/80）, 25.00% （20/80）, 15.00% （12/80） respectively. Of which, contents of HBV-DNA of all 44 pregnant women with positive HBsAg, HBeAg and HBcAb were more than 103 copies/mL, while the content of HBV-DNA of only 1 pregnant woman among 31 pregnant women with positive HBsAg, HBeAb, HBcAb was more than 103 copies/mL, the difference between the two groups was significant （χ2=70.968,P〈0.001）. The positive detectable rates of HBsAg, HBeAg and HBVDNA in umbilical blood of the neonates born by 44 pregnant women with positive HBsAg, HBeAg and HBV-DNA were 31.82% （14/44）, 45.45%（20/44）, 27.27% （12/44） respectively, while those in umbilical blood of neonates born by 31 pregnant women with positive HBsAg, HBeAb, HBcAb were zero and their HBV-DNA conents were all less than 103 copies/mL, the differences between the two groups were significant （χ2 =12.127, 19.215, 10.065 respectively, all P〈0.01）. 12 HBV-DNA positive neonates were all born by those pregnant women with positive HBsAg, HBeAg, HBcAb and whose HBV-DNA contents were more than 105 copies/mL. Conclusion Positive HBsAg, HBeAg, HBcAb and high content of HBVDNA （〉105copies/mL） in serum of pregnant women are most important high risk factors of trauterine infection of HBV by motherchild vertical

关 键 词：妊娠 乙型肝炎 病毒载量 宫内感染 

分 类 号：R512.62[医药卫生—内科学] R714[医药卫生—临床医学]