西安市HBV宫内感染的发生情况及其影响因素研究  

HBV intrauterine infection and its influencing factors in Xi'an

作　　者：黄睿 曹引丽[3] 高洁 续靖宁[3] 杨芳 付婷[1] 张维璐[1] 张磊[1] 闫永平[1] 

机构地区：[1]第四军医大学,陕西西安710032 [2]渭南职业技术学院 [3]西北妇女儿童医院

出　　处：《华南预防医学》2017年第6期507-511,共5页South China Journal of Preventive Medicine

基　　金：国家自然科学基金青年项目(项目编号:81102140);国家自然科学基金面上项目(项目编号:81472988;81172731;81370082)

摘　　要：目的对西安地区HBsAg阳性孕妇及其新生儿HBV显性感染和隐性感染情况进行调查,并对发生宫内感染的影响因素进行分析。方法对2012年1月至2015年9月期间于陕西省妇幼保健院分娩的HBsAg阳性孕妇进行问卷调查并对其所生新生儿于产后24 h内静脉血进行血清学检测,对调查结果和检测结果进行描述流行病学分析,并对新生儿HBV宫内感染影响因素进行单、多因素分析。结果共对294例HBsAg阳性产妇进行调查,平均年龄为(29±3.5)岁,年龄范围为20~45岁。共检测了297名新生儿(含3对双胞胎),HBV宫内感染率为48.1%(143/297),其中显性感染率为8.08%(24/297),HBV宫内隐匿性感染率为40.07%(119/297)。多因素分析结果显示,产妇HBeAg阳性(OR=1.813)、外周血HBV DNA浓度越高(OR=1.707、2.499、2.259)、前置胎盘(OR=3.056)和孕期未注射高效价免疫球蛋白(OR=2.787),新生儿发生宫内感染的可能性更高。结论西安地区HBsAg阳性孕妇所生新生儿HBV宫内感染率较高,且HBV宫内隐匿性感染情况较为严重,建议临床中加强对HBsAg阳性且HBV DNA>200 IU/mL的育龄妇女的健康指导。Objective To investigate HBV apparent and occult infections in HBsAg positive preg- nant women and their newboms and explore factors influencing intrauterine infection in Xi＇an City. neth- otis HBsAg-positive pregnant women were recruited in Shanxi Provincial Maternal and Child Health Care Hospital from January 2012 to September 2015 for questionnaire survey. Their neonatal blood samples were collected within 24 hours postpartum for serologic testing. Survey results and testing results were described and analyzed by epidemiological method. Multivariate logistic regression was used to analyze factors influ- encing HBV intrauterine infection of newborns. Results A total of 294 mothers with HBsAg participated in the study. Their ages ranged from 20 to 45 years and average age was （29 ~ 3.5） years. A total of 297 newborns （ including 3 pairs of twins） were tested. The HBV intrauterine infection rate was 48.1% （ 143/ 297 ）, including 8.08% （24/297） of apparent infection rate and 40.07% （ 119/297 ） of intrauterine oc- cult infection rate. Multivariate logistic regression showed that mothers with HBeAg （OR = 1. 813）, the higher concentration of HBV DNA in peripheral blood （ OR = 1. 707, 2.499, 2. 259）, placenta previa （ OR = 3. 056）, and without injection of hepatitis B immunoglobulin during pregnancy （ OR = 2.787 ） were more likely to occur neonatal infection. Conclusion Newborns delivered by HBsAg positive pregnant women had high HBV intrauterine infection rate and HBV intrauterine occult infection was serious in Xi＇an.It is recommended to strengthen the health education for women at childbearing age with HBsAg and HBV DNA 〉 200 IU / mL.

关 键 词：肝炎 乙型 婴儿 新生 感染 因素分析 统计学 

分 类 号：R174.6[医药卫生—妇幼卫生保健]