553例产妇血清、乳汁、唾液中乙型肝炎病毒-DNA载量的检测及相关性研究  

Correlation of Hepatitis B Virus DNA Load among Serum,Milk,and Saliva in Parturient:553 Cases Analysis

作　　者：张静 黄晨艳[1] 

机构地区：[1]安徽省合肥市妇幼保健院,安徽合肥230001

出　　处：《实用妇产科杂志》2012年第4期294-297,共4页Journal of Practical Obstetrics and Gynecology

基　　金：安徽省合肥市科技局医学应用性研究项目(编号:HF20082642)

摘　　要：目的:探讨乙型肝炎病毒(HBV)携带产妇血清中HBV标志物感染模式(HBV-M)、HBV-DNA载量与乳汁、唾液中HBV-DNA阳性率的关系,为安全进行母乳喂养和母婴亲密接触提供循证医学依据。方法:选取467例HBV携带产妇(实验组,又分为大三阳组、小三阳组和单纯阳性组)和同期86例乙型肝炎五项指标全阴的产妇(对照组),用ELISA和实时荧光定量多聚酶链反应(PCR)方法,检测产妇血清HBV-M及血清、乳汁、唾液中HBV-DNA载量,分析乳汁、唾液中HBsAg阳性率、HBV-DNA阳性率与血清HBV-M的关系,以及乳汁、唾液HBV-DNA阳性率与血清HBV-DNA载量的相关性。结果:实验组中血清大三阳组,乳汁和唾液中HBsAg阳性率和HBV-DNA阳性率均明显高于小三阳组、单纯阳性组及对照组,两两比较差异均有高度统计学意义(P<0.01);实验组唾液HBsAg总阳性率与HBV-DNA总阳性率均高于乳汁(P<0.01);乳汁和唾液HBV-DNA阳性率与血清HBV-DNA载量呈正相关(r=0.976,P<0.01;r=0.999,P<0.01)。结论:血清大三阳产妇传染性较强;HBV携带产妇的唾液较乳汁更具有传染性;随着血清HBV-DNA载量的增加,乳汁、唾液中HBV-DNA阳性率增加,传染性增强。Objective： To probe the relationship of hepatitis B virus serum markers （HBV-M） mode, HBV-DNA load and positive rate of HBV-DNA in milk and saliva in HBV-infected pregnant women to provide medical evidence for safe breast-feeding and close contact between mothers and infants. Methods： 467 HBV-infected pregnant women （experimental group, including HBsAg/HBeAg/HBcAb positive, HBsAg/ HBeAb/HBcAb positive, HBsAg positive） and 86 normal pregnant women （control group with all markers negative） were selected in this study. HBV-M and loads of HBV-DNA in serum, milk, and saliva were detec- ted by enzyme linked immunosorbent assay （ELISA） and fluorescent quantitative polymerase chain reaction （PCR）. The relationships among positive rates of HBsAg, HBV-DNA in milk and saliva, and serum HBV-M were analyzed, as well as and the relationship between the load of HBV-DNA and positive rates of HBV-DNA in milk and saliva were also analyzed. Results：The positive rate of HBsAg and HBV-DNA in the milk and sa- liva of double positive group （HBsAg/HBeAg/HBcAb） were higher than other groups includes single positive group （HBsAg/HBeAb/HBcAb）, HBsAg/HBcAb group and all negative control group, and there were sig- nificant difference among the other two groups（ P〈O. 01 ）. In experimental group, the positive rates of HB- sag and HBV-DNA in saliva were higher than milk（ P 〈0.01 ）. There was positive relationship between the positive rate of HBV-DNA and the load of HBV in serum and milk and saliva（ r=0. 976, P 〈0. 01, r=0. 999, P〈O. 01 ）. Conclusions：The infectivity in double positive group （HBsAg/HBeAg/HBcAb） is higher. There is much more transmission of HBV in saliva than milk in HBV-infected pregnant women. With the increase of serum HBV-DNA load, the positive rate of HBV-DNA in their milk, and saliva and infectivity are also in- creased.

关 键 词：乙型肝炎病毒-DNA 实时荧光定量多聚酶链反应 母乳喂养 唾液 

分 类 号：R512.6[医药卫生—内科学]