乙型肝炎病毒感染产妇血清病毒载量和e抗原表达与乳汁中病毒载量的相关性研究  

Correlation between serum hepatitis B virus DNA load,status of hepatitis B e antigen and viral load in breast milk of hepatitis B virus-infected parturients

作　　者：曹璟宜[1] 杨二娜[2] 于爱萍[3] 宁淑敏[3] 

机构地区：[1]天津医学高等专科学校,300222 [2]解放军总医院学员队 [3]天津市第二人民医院

出　　处：《中华传染病杂志》2016年第10期582-585,共4页Chinese Journal of Infectious Diseases

摘　　要：目的：探讨 HBV 感染产妇血清 HBV DNA 载量和 HBeAg 表达状况与乳汁 HBV DNA载量的相关性。方法选择2010年1月至2013年7月在天津市第二人民医院分娩的 HBV 感染产妇370例，将 HBsAg、HBeAg、抗-HBc 阳性者纳入 HBeAg 阳性组；HBsAg、抗-HBe、抗-HBc 阳性者纳入HBeAg 阴性组。同时检测血清和产后24 h 内乳汁的 HBV DNA 载量。组间计数资料比较采用χ^2检验，计量资料比较采用 t 检验，相关性检验采用 Pearson 相关分析。结果370例产妇中 HBeAg 阳性组174例（47．0％），血清 HBV DNA 为（6．03±0．86）lg 拷贝／mL ；HBeAg 阴性组196例（53．0％），血清HBV DNA 为（4．04±0．61）lg 拷贝／mL，两组比较差异有统计学意义（t ＝25．883，P 〈0．01）。HBeAg阳性组 HBV DNA〉1×10^5拷贝／mL 者118例，其中86例（72．9％）乳汁中 HBV DNA〉500拷贝／mL，乳汁中 HBV DNA 载量随着血清 HBV DNA 载量的升高而升高。 HBeAg 阳性组中 HBV DNA〉1×10^5且≤1×10^7拷贝／mL 与〉1×10^7拷贝／mL 检出率比较差异有统计学意义（χ^2＝16．238， P 〈0．01）；HBeAg 阴性组中 HBV DNA〉1×10^5且≤1×10^7拷贝／mL 与〉1×10^7拷贝／mL 检出率比较差异亦有统计学意义（χ^2＝6．453，P 〈0．01）。但在 HBV DNA〉1×10^5且≤1×10^7拷贝／mL 的HBeAg 阳性组和阴性组之间检出率比较差异无统计学意义（χ^2＝0．029，P ＝0．864），HBV DNA〉1×10^7拷贝／mL 的 HBeAg 阳性组和阴性组之间检出率比较，差异亦无统计学意义（χ^2＝0．002，P ＝0．965）。结论 HBV 感染产妇血清 HBeAg 阳性者对乳汁的传播概率高于阴性者，产妇血清 HBV DNA载量决定其乳汁中 HBV DNA 水平。血清 HBeAg 阳性与否，与产妇乳汁中 HBV DNA 水平无相关性。Objective To study the correlation between hepatitis B virus （HBV）DNA load, hepatitis B e antigen （HBeAg）status and the viral load in breast milk of HBV-infected parturients. Methods A total of 370 HBV-infected parturients who delivered in the Second People′s Hospital of Tianjin between January 2010 and July 2013 were selected.Patients with hepatitis B surface antigen （HBsAg）positive,HBeAg （＋）and hepatitis B core antibody （＋）were put in HBeAg-positive group, those with HBsAg （＋）,hepatitis B e antibody （＋）and hepatitis B core antibody （＋）were included in HBeAg-negative group.HBV DNA levels in serum and breast milk within 24 hours postpartum were detected.Count data between groups were compared by chi-square test.Measurement data were compared by using t test.Correlation analysis was conducted by Pearson correlation analysis.Results 174 out of 370 parturients （47.0%）were included in HBeAg-positive group with serum HBV DNA load of （6.03 ＋0.86）lg copies/mL.And 196 cases （53.0%）were included in HBeAg-negative group with serum HBV DNA （4.04 ＋ 0.61）lg copies/mL.The difference between the two groups was statistically significant （t=25.883,P〈0.01）.118 cases in HBeAg-positive group had serum HBV DNA 〉 1 × 10^5 copies/mL. Among them,86 cases （72.9%）had HBV DNA〉500 copies/mL in milk.The viral load in breast milk increased with that in serum.The comparison of detection rates of HBV DNA 〉1×10^5 - 1×10^7 copies/mL and〉1 × 10^7 copies/mL in both HBeAg-positive and HBeAg-negative groups were both statistically significant （χ^2=16.238 and 6.453,respectively,both P 〈 0.01）.However,the comparison of HBV DNA 〉1×10^5 - 1 × 10^7 copies/mL between HBeAg-positive group and HBeAg-negative group did not reach statistical significance （χ^2=0.029,P=0.864）.And there was no statistically significant differences between HBeAg-positive group and HBeAg-negative group for HBV DNA 〉 1 × 10^7 copies/mL （χ^2=0. 002,P = 0.965 ）.Conclusions The

关 键 词：乙型肝炎病毒携带产妇 肝炎e抗原 乙型 HBV DNA 载量 乳汁 母亲 

分 类 号：R714.251[医药卫生—妇产科学]