泰安市乙型肝炎病毒宫内传播影响因素分析  

Influencing factors of intrauterine transmission of hepatitis B virus in Tai’an City

作　　者：邓阳[1] 王芳[1] 张海涛 DENG Yang;WANG Fang;ZHANG Hai -tao(School of Public Health,Taishan Medical University,Tai'an,Shandong 271016,China)

机构地区：[1]泰山医学院公共卫生学院,山东泰安271016 [2]泰安市妇幼保健院,山东泰安271000

出　　处：《现代预防医学》2018年第23期4281-4285,共5页Modern Preventive Medicine

基　　金：山东省自然科学基金培养项目(ZR2017PH012);山东省自然科学基金面上项目(ZR2012HM082)

摘　　要：目的探讨泰安市乙型肝炎病毒表面抗原(HBs Ag)阳性母亲分娩的新生儿发生乙型肝炎病毒(HBV)宫内跨胎盘传播的影响因素。方法纳入567例HBs Ag阳性母亲及其新生儿作为研究对象,收集母亲一般信息及抗病毒治疗等资料,检测母亲及新生儿HBV标志物、HBV DNA等指标。统计分析采用χ2检验和非条件多因素logistic回归。结果泰安市HBs Ag阳性母亲所分娩的新生儿HBV宫内传播的发生率为11. 46%。单因素分析显示母亲年龄、孕晚期乙型肝炎免疫球蛋白干预、乙型肝炎病毒e抗原(HBeAg)、HBV DNA浓度和HBV基因型与新生儿宫内传播的发生有关(P <0. 05)。Logistic回归分析显示,母亲HBeAg(OR=3. 350,95%CI=1. 889~6. 964)和HBV DNA浓度(OR=2. 096,95%CI=1. 585~5. 508)是HBV宫内传播的影响因素。以阴性为对照,母亲HBV DNA低载量组调整OR值为1. 211(95%CI:1. 110~1. 565),高载量组调整OR值为1. 948(95%CI:1. 345~2. 784),母亲HBV DNA浓度与宫内传播之间存在线性趋势(χ2=6. 920,P=0. 009)。结论 HBs Ag阳性母亲伴HBeAg阳性和高HBV DNA浓度是造成泰安市HBV宫内跨胎盘传播的主要危险因素,且HBV DNA浓度越高,发生宫内传播的可能性越大。Objective To investigate the influencing factors of intrauterine transmission of HBV in neonates born to hepatitis B surface antigen (HBsAg)-positive mothers in Tai'an City.Methods :We recruited 567 HBsAg -positive mothers and their neonates and collected general information and antiviral treatment of HBsAg -positive mothers.HBV serological markers and HBV DNA load were tested in the laboratory.The influencing factors of intrauterine transmission were analyzed by chi -square test and unconditioned multivariate logistic regression model.Results The rate'of intrauterine transmission of HBV in neonates born to HBsAg -positive mothers was 11.46%in Tai'an City.The univariate analysis showed that age,hepatitis B immunoglobulin intervention in late pregnancy,hepatitis B e antigen (HBeAg),HBV DNA level and HBV genotype of HBsAg -positive mothers were related to intrauterine transmission of HBV in neonates (P <0.05).The logistic regression model analysis showed that HBeAg (OR =3.350,95%CI =1.889-6.964)and HBV DNA level (OR =2.096,95%CI =1.585- 5.508)were influencing factors in the intrauterine transmission of HBV.Taking the negative level of HBV DNA as control,the adjusted ORs were 1.211(95%CI:1.110-1.565)in low viral load group and 1.948(95%CI:1.345-2.784)in high viral load group,respectively.There was a linear trend between HBV DNA level and intrauterine transmission (χ2=6.920,P =0.009).It suggested that the higher HBV DNA level of HBsAg positive mothers,the higher rate of intrauterine transmission.Conclusion HBsAg -positive mothers with HBeAg -positive and high HBV DNA level are the main risk factors of intrauterine transmission of HBV in Tai'an City,and the higher the HBV DNA concentration,the greater the possibility of intrauterine transmission.

关 键 词：泰安市 乙型肝炎病毒 宫内传播 新生儿 影响因素 

分 类 号：R17[医药卫生—妇幼卫生保健]