不同分娩方式对不同HBV DNA载量乙型肝炎母婴垂直传播的影响  

Influence of different delivery modes on mother-to-infant vertical transmission of different viral loads of HBV DNA

作　　者：赵新敏[1] 高云霞[2] 张举[3] 张园园[4] 李婷 

机构地区：[1]南阳医学高等专科学校第一附属医院护理部,河南南阳473000 [2]南阳医学高等专科学校第一附属医院儿科一病区,河南南阳473000 [3]南阳医学高等专科学校第一附属医院产科,河南南阳473000 [4]南阳医学高等专科学校第一附属医院妇科,河南南阳473000

出　　处：《中华医院感染学杂志》2017年第2期422-424,共3页Chinese Journal of Nosocomiology

基　　金：河南省卫生计生委科技攻项目(201406024)

摘　　要：目的探讨不同分娩方式对不同HBV DNA载量乙型肝炎母婴垂直传播的影响。方法选取2015年1月-2016年5月乙肝表面抗原阳性产妇281例,将产妇分为低HBV DNA拷贝组(<106 copies/ml)169例(包括剖宫产分娩92例,经阴分娩77例)和高HBV DNA拷贝组(≥106 copies/ml)112例(包括剖宫产分娩62例,经阴分娩50例),统计分析婴儿出生后的HBV抗原、HBV DNA阳性率和免疫阻断效果。结果低HBV DNA拷贝组不同分娩方式新生儿出生时的HBsAg阳性率、HBeAg阳性率以及HBV DNA阳性率比较,差异无统计学意义;高HBV DNA拷贝组剖宫产分娩组新生儿的HBsAg阳性率和HBV DNA阳性率明显低于经阴分娩组,两组比较差异有统计学意义(P<0.05)。结论高HBV DNA拷贝孕妇采用经阴分娩的HBV垂直感染机会较大,后期可采取母婴阻断措施对其进行阻断。OBJECTIVE To explore the influence of different delivery modes on mother-to-infant vertical transmission of different viral loads of HBV DNA. METHODS A total of 281 pregnant women who were positive for hepatitis B surface antigen from Jan 2015 to May 2016 were enrolled in the study and divided into the low HBV DNA copy group （less than 106 copies/roD with 169 cases （including 92 cases of cesarean section and 77 cases of vaginal delivery） and the high HBV DNA group （more than 106 eopies/ml） with 112 cases （including 62 cases of cesarean section and 50 vaginal delivery）. The HBV antigen, positive rate of HBV DNA, and immune blocking effects were statistically analyzed after the infants were born. RESULTS There was no significant difference in the positive rate of HBsAg, positive rate of HBeAg, or positive rate of HBV DNA among the neonates with different delivery modes in the low HBV DNA group. In the high HBV DNA copy group, the positive rate of HBsAg and the positive rate of HBV DNA were significantly lower in the neonates who were delivered by cesarean section than in the neonates who were delivered via vaginal delivery, and there was significant difference （P〈0.05）. CONCLUSION The pregnant women with high HBV DNA copy who receive the vaginal delivery are more likely to acquire the vertical infection with HBV, and the mother-to-infant blocking measures should be taken in the later period so as to block the transmission.

关 键 词：分娩方式 HBV DNA 母婴垂直传播 

分 类 号：R512.62[医药卫生—内科学]