HBV感染孕妇阻断宫内传播失败的影响因素  

Influencing factors for failure of blocking intrauterine transmission in pregnant women with HBV infection

作　　者：来国红 孙岳琴[1] 袁茶娟 张利萍 沈丹丹 LAI Guo-hong;SUN Yue-qin;YUAN Cha-juan;ZHANG Li-ping;SHEN Dan-dan(Xiaoshan District First People's Hospital,Hangzhou,Zhejiang 311200,China)

机构地区：[1]杭州市萧山区第一人民医院产科,浙江杭州311200

出　　处：《中华医院感染学杂志》2023年第2期257-260,共4页Chinese Journal of Nosocomiology

基　　金：浙江省科研基金计划项目(2020126)。

摘　　要：目的探讨乙肝病毒(HBV)感染孕妇阻断宫内传播失败的影响因素。方法选择2019年1月-2020年8月于杭州市萧山区第一人民医院进行产科检查的HBV感染孕产妇286例为研究对象,给予相应的抗病毒治疗及新生儿阻断免疫接种程序,根据新生儿7月龄血清学检测结果分为阻断成功组和阻断失败组,检测两组HBV-DNA、HBV-RNA载量,乙肝病毒感染血清标志物检测乙肝表面抗原(HBsAg)、乙肝表面抗体(HBsAb)、乙肝e抗原(HBeAg)、乙肝e抗体(HBeAb)、乙肝核心抗体(HBcAb),肝生化指标丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)、总胆红素(TBIL)和直接胆红素(DBIL)及影像学检查。结果阻断失败组肝脏B超改变例数所占比例高于阻断成功组(P<0.05);阻断成功组和阻断失败组基线HBV-DNA、基线HBV-RNA和HBsAg比较差异有统计学意义(P<0.05);多因素Logistics回归分析结果显示,肝脏B超改变、基线HBV-DNA、HBV-RNA和HBsAg为HBV感染孕产妇阻断治疗失败的影响因素(P<0.05)。结论阻断失败组孕妇基线HBV-DNA、HBV-RNA和HBsAg水平较高,肝脏B超改变、基线HBV-DNA、HBV-RNA和HBsAg水平均为HBV母婴阻断失败的影响因素。OBJECTIVE To explore the influencing factors for failure of blocking intrauterine transmission of hepatis B virus(HBV)infection in pregnant women.METHODS A total of 286 pregnant women with HBV infection who received obstetric examination in Xiaoshan District First People′s Hospital from Jan 2019 to Aug 2020 were recruited as the research subjects and were given corresponding antiviral therapies and neonatal immunization interrupt procedures.The subjects were divided into the successful block group and the failed block group according to the result of serological test for the neonates at the age of 7 months.The HBV-DNA load,HBV-RNA,serologic markers for HBV infection such as hepatitis B surface antigen(HBsAg),hepatitis B surface antibody(HBsAb),hepatitis B e antigen(HBeAg),hepatitis B e antibody(HBeAb)and hepatitis B core antibody(HBcAb)as well as hepatic biochemical indexes alanine aminotransferase(ALT),aspartate aminotransferase(AST),total bilirubin(TBIL)and direct bilirubin(DBIL)were observed and compared between the two groups,and the imaging characteristics were analyzed.RESULTS The proportion of the cases with change of liver B ultrasound was higher in the failed block group than in the successful block group(P<0.05).There were significant differences in the backline HBV-DNA,baseline HBV-RNA and HBsAg between the successful block group and the failed block group(P<0.05).The result of multivariate logistic regression analysis showed that the change of liver B ultrasound,baseline HBV-DNA,HBV-RNA and HBsAg were the influencing factors for the failure of blocking the transmission of HBV infection in the pregnant women(P<0.05).CONCLUSION The baseline HBV-DNA,HBV-RNA and HBsAg levels of the pregnant women in the failed block group are relatively high.The change of liver B ultrasound,baseline HBV-DNA,HBV-RNA and HBsAg levels are the influencing factors for the failure of blocking the transmission of HBV infection from mother to infant.

关 键 词：乙肝病毒 孕妇 宫内传播 阻断失败 影响因素 

分 类 号：R512.62[医药卫生—内科学]