产妇合并不同HBV感染模式产后血清与唾液及乳汁HBV-DNA载量测定的意义及相关性分析  

Significance and correlation analysis of HBV-DNA in postpartum serum,saliva and milk of parturients with different HBV infection patterns

作　　者：季红薇[1] 廖燕[1] 赵红艳[1] 张贵英 陈晓方[1] JI Hong-wei;LIAO Yan;ZHAO Hong-yan;ZHANG Gui-ying;CHEN Xiao-fang(Lishui Central Hospital of Obstetrics and Gynecology,Lishui,Zhejiang 323000,China)

机构地区：[1]丽水市中心医院妇产科,浙江丽水323000

出　　处：《中华医院感染学杂志》2018年第16期2442-2445,共4页Chinese Journal of Nosocomiology

基　　金：浙江省医药卫生科学研究基金资助项目(2014-KYA278)

摘　　要：目的探讨产妇合并不同乙型肝炎病毒(HBV)感染模式产后血清、唾液及乳汁HBV-DNA载量测定的意义及相关性。方法选取2015年9月-2017年5月于医院就诊的即将分娩产妇共96例为研究对象,所有产妇产前检查血清乙肝指标均为阳性,根据不同HBV感染模式将96例患者分为甲、乙、丙三组;乙肝表面抗原(HBsAg)、乙肝e抗原(HBeAg)、乙肝核心抗体(HBcAb)阳性为甲组("大三阳"急性期32例);HBsAg、乙肝e抗体(HBeAb)、HBcAb阳性为乙组("小三阳"恢复期32例);HBsAg、HBcAb阳性为丙组(慢性期32例);分析各组产妇产后血清、唾液及乳汁HBV-DNA载量及相关性。结果甲组产妇血清、乳汁及唾液HBV-DNA阳性率分别为90.63%、62.50%、59.38%,高于乙组71.88%、40.63%、34.38%,丙组43.75%、25.00%、18.75%(P<0.05);甲组产妇血清、乳汁及唾液中HBV-DNA载量分别为(5127.45±350.80)copies/mL、(4210.20±294.04)copies/mL、(2147.15±224.86)copies/mL,高于乙组和丙组,乙组HBV-DNA载量高于丙组(P<0.05);甲组新生儿HBV感染率为81.25%,高于乙组的50.00%和丙组的28.13%,乙组新生儿HBV感染率高于丙组(χ~2=42.51,P<0.001),产妇分娩前HBV-DNA载量与新生儿HBV感染率呈正相关。结论产妇分娩前HPV-DNA载量越高,分娩后唾液及乳汁中HPV-DNA载量也越高,两者呈正相关,产前积极开展HBV感染治疗和预防能降低新生儿感染率,减少分娩风险。OBJECTIVE To investigate the significance and correlation of postpartum serum,saliva and breast milk HBV-DNA load in maternal women with different hepatitis B virus（HBV）infection patterns.METHODS From September 2015 to May 2017,a total of 96 women who were present at the obstetric department in our hospital were selected as objects for this study.All maternal prenatal tests were positive for serum hepatitis B,and 96 patients were divided into groups A,B,and C according to different HBV infection patterns.HBsAg,HBeAg,and HBcAb were positive in group A（32 cases in the acute phase of ＂ serious triple positive results＂）.HBsAg,HBeAb,and HBcAb were positive in group B（32 cases in the recovery period of ＂ mild triple positive results＂）.Positive HBsAg and HBcAb were in group C（32 cases in chronic phase）.HBV-DNA load in postpartum serum,saliva,and milk in each group and their correlations were analyzed.RESULTS The positive rates of HBV-DNA in serum,milk and saliva of group A were 90.63%,62.50% and 59.38%,which were significantly higher than those of group B（71.88%,40.63%,34.38%）and group C（43.75%,25.00%,18.75%）（P〈0.05）.The HBV-DNA load in maternal serum,milk and saliva of group A（5127.45±350.80,4210.20±294.04,2147.15±224.86）was significantly higher than those of group B（4345.41±340.55,3211.10±291.84,1124.42±194.43）and group C（3210.15±247.34,2141.01±250.64,842.45±156.33）（P〈0.05）.The probability of HBV infection in newborns in group A（81.25%）was significantly higher than those in group B（50.00%）and group C（28.13%）（P〈0.05）.It was proved that the HBV-DNA load before maternal delivery and neonatal HBV infection rate were positively correlated.CONCLUSIONThe higher the HPV-DNA load before parturition,the higher the HPV-DNA load in saliva and milk after delivery.The two are positively correlated.The active treatment and prevention of HBV infection before birth can reduce the incidence of neonatal infection and reduce childbirth risks.

关 键 词：HBV感染 血清 唾液 产妇乳汁 HBV-DNA载量 相关性 

分 类 号：R512.62[医药卫生—内科学]