乙型肝炎产妇血清与乳汁HBV标志物检测意义  

Clinical significance of detection of hepatitis B virus markers in serum and milk on parturients with hepatitis B

作　　者：陈铭[1] 艾彪[1] 何瀚[1] 董虹[1] 谢良才[1] 周铭[1] 

机构地区：[1]湖北省荆州市第一人民医院检验科,434000

出　　处：《检验医学与临床》2010年第6期517-518,521,共3页Laboratory Medicine and Clinic

摘　　要：目的调查乙型肝炎(下称乙肝)病毒携带产妇血清乙肝病毒DNA(HBV-DNA)含量、乙肝血清免疫学指标与乳汁中HBV-DNA含量及阳性率的关系,以指导母乳喂养。方法选择血清乙肝表面抗原(HBsAg)为阳性的乙肝携带者的产妇116例,采用酶联免疫吸附试验(ELISA)检测血清及乳汁中免疫血清学标志物;荧光定量聚合酶链反应(FQ-PCR)技术测定血清与乳汁与中HBV-DNA含量,并对所有检测指标进行相关性分析。结果在ELISA检测中HBsAg乳汁中阳性率为62.1%,低于血清结果差异有统计学意义(P<0.01);其他免疫学标志物乙肝e抗原(HBeAg)、乙肝病毒表面抗体(HBsAb)、乙肝病毒e抗体(HBeAb)、前S1抗原差异无统计学意义(P>0.05)。HBV-DNA检测结果中HBeAg阳性组血清HBV-DNA阳性率97.6%,乳汁HBV-DNA阳性率85.7%,二者差异无统计学意义(P>0.05);HBeAb阳性组血清HBV-DNA阳性率12.1%,乳汁HBV-DNA检2例,阳性率2.7%,二者差异有统计学意义(P<0.05)。乳汁HBV-DNA的含量随血清HBV-DNA含量的升高而增大,二者呈正相关(r=0.864,P<0.05)。结论乙肝产妇免疫学标志物不只是能决定进行母乳喂养的指标,同时还应检测血清HBV-DNA与乳汁HBV-DNA,两者均为阴性才能进行哺乳。Objective To investigate the correlation between the level of hepatitis B virus DNA（HBV-DNA） and immune marks in serum and milk of parturients with hepatitis B and instruct the breast feeding.Methods 116 parturiens with hepatitis B were selected and the hepatitis B virus immune marks in serum and milk were detected by ELISA while hepatitis B virus DNA were examed by FQ-PCR,and the correlation of the detecting results was analyzed.Results The positive rate of HBsAg in milk is 62.1%,which is lower than that of HBsAg in serum（P〈0.01）;there was no significant difference in the positive rate of HBeAg、HBsAb、HBeAb、pre-s1antigen in serum and milk（P〉0.05）.But there was a significant difference about the HBV-DNA in serum and milk in HBeAb positive group（P〈0.05）.The copy of HBV-DNA in milk increased with the rise of HBV-DNA in serum（r=0.864,P〈0.05）.Conclusion Since the immune marks in serum and milk of parturients with hepatitis B could not determine whether they do breast feeding, the copy of HBV-DNA in serum and in milk should be analyzed simultaneously.

关 键 词：乙型肝炎病毒 母乳喂养 病毒复制 

分 类 号：R512.7[医药卫生—内科学]