携带乙型肝炎病毒产妇血清与初乳HBV DNA载量关联性研究  

The Relationship between Serum HBV DNA Quantities and Colostrum HBV DNA Quantities among HBV-positive Lying-in Women

作　　者：黄晨艳[1] 方有兵[2] 蔡娟[1] 黛垠之[1] 陆天慧[1] 王黎[1] 李启发[1] 孟祥莲[1] 张育苗[1] 陶芳标[3] 

机构地区：[1]安徽医科大学附属临床妇幼学院,合肥市妇幼保健院 [2]安徽医科大学第一附属医院,合肥230001 [3]安徽医科大学公共卫生学院儿少卫生与妇幼保健学系,安徽省人口健康与优生省级实验室

出　　处：《临床输血与检验》2011年第1期10-14,共5页Journal of Clinical Transfusion and Laboratory Medicine

基　　金：安徽省合肥市科技局医学应用性研究项目(No.HF20082642)资助

摘　　要：目的研究产妇血清与其初乳汁乙型肝炎病毒(HBV)DNA载量的关联性。方法选取住院分娩产妇共522例,依据HBV五项血清学指标,分为A组:乙肝"HBsAg、HBeAg、HBcAb均阳性"103例,B组:乙肝"HBsAg、HBeAb、HB-cAb均阳性"221例,C组:HBsAg、HBeAg阳性20例,D组:HBsAg、HBcAb阳性43例,E组:乙肝其他血清模式49例,另选F组:HBV模式全阴性的产妇86例作为对照组;均采用ELISA法检测产妇血清、乳汁中HBV标志物HBsAg、HBsAb、HBeAg、HBeAb、HBcAb,阳性者采用该项目胶体金标试纸复核,同时采用实时荧光定量PCR检测产妇血清和乳汁HBVDNA载量,对相关数据进行统计分析。结果对年龄18～44岁围产期妇女体检乙肝感染指标,A组乙肝"HBsAg、HBeAg、HBcAb均阳性"产妇血清和乳汁HBV DNA诊断灵敏度分别为100.00%(103/103)和86.41%(89/103)、血清HBV DNA载量平均为4.11×108copies/ml;B组乙肝"HBsAg、HBeAb、HBcAb均阳性"产妇血清和乳汁HBV DNA诊断灵敏度分别为19.46%(43/221)和2.71%(6/221),血清HBV DNA载量平均为6.85×104copies/ml;C组乙肝HBsAg、HBeAg阳性产妇血清和乳汁HBV DNA诊断灵敏度分别为100.00%(20/20)和80.00%(16/20),血清HBV DNA载量平均为8.27×106copies/ml;D组HBsAg、HBcAb阳性产妇血清和乳汁HBV DNA诊断灵敏度分别为65.12%(28/43)和25.58%(11/43),血清HBV DNA载量平均为2.89×105copies/ml;E组HBV其他模式产妇血清和乳汁HBV DNA诊断灵敏度分别为10.20%(5/49)和2.04%(1/49),血清HBV DNA载量平均为1.59×104copies/ml;F组乙肝五项全阴性产妇血清和乳汁HBV DNA诊断灵敏度分别为1.16%(1/86)和0(0/86),血清HBV DNA载量<1.00×103copies/ml。A组与B组间乳汁HBV DNA实验诊断阳性差异有统计学意义(χ2=237.45,P<0.01)。HBV携带者乳汁HBV DNA载量与其血液HBVDNA载量呈正相关(r=0.721)。结论携带HBV产妇乳汁HBV DNA载量远低于血液HBV DNA载量;乳汁中HBV传染性也低于血液传染性;研究证实A组产妇经母乳HBV传染性是"HBsAg、HBeAb、HBcAb均阳性"产Objective To explore the relationship between serum HBV DNA quantities and colostrum HBV DNA quantities among 522 HBV-positive lying-in women.Methods 522 lying-in women were selected according to the principle of inform consent.These women were classified into 6 groups.Group A： 103 lying-in women with strong-infectious HBV（three positives）,group B： 221 lying-in women with weak-infectious HBV（three positives）,group C： 20 lying-in women with the first and third positive HBV,group D： 43 lying-in women with the first and fifth positive HBV,group E： 49 other HBV types and the control group F： 86 HBV-negative lying-in women.The HBV benchmark including HBsAg,HBsAb,HBeAg,HBeAb and HBcAb in the blood serum and colostrum of the selected women were detected by ELISA.Furthermore,PCR was utilized to measure the serum HBV DNA quantities and colostrum HBV DNA quantities among the lying-in women.The data was analyzed after been collected.Results The blood serum HBV DNA diagnosis sensitivity and colostrum HBV DNA diagnosis sensitivity among the lying-in women in group A were 100.00 %（103/103） and 86.41%（89/103）,and their average blood serum HBV DNA quantity was 4.11×10^8 copies/ml;the serum HBV DNA diagnosis sensitivity and colostrum HBV DNA diagnosis sensitivity among the lying-in women in group B were 19.46%（43/221）and 2.71%（6/221）,and their average serum HBV DNA quantity was 6.85×10^4 copies/ml;the serum HBV DNA diagnosis sensitivity and colostrum HBV DNA diagnosis sensitivity among the lying-in women in group C were 100.00 %（20/20）and 80.00%（16/20）,and their average blood serum HBV DNA quantity was 8.27×10^6 copies/ml;the serum HBV DNA diagnosis sensitivity and colostrum HBV DNA diagnosis sensitivity among the lying-in women in group D were 65.12%（28/43） and 25.58%（11/43）,and their average serum HBV DNA quantity was 2.89×10^5 copies/ml;the serum HBV DNA diagnosis sensitivity and colostrum HBV-DNA diagnosis sensitivity among the lying-in women in group E were 10.20 %（5/

关 键 词：围生期 乙型肝炎病毒载量 母乳喂养 

分 类 号：R512.62[医药卫生—内科学] R392.11[医药卫生—临床医学]