乙型肝炎病毒宫内感染的随访研究  

A follow-up study of hepatitis B virus intrauterine infection

作　　者：刘一萍[1] 门可[1] 徐德忠[1] 王安辉[1] 徐剑秋 闫永平[1] 

机构地区：[1]第四军医大学预防医学系流行病学教研室,陕西西安710033 [2]陕西省妇幼保健医院产科,陕西西安710003

出　　处：《第四军医大学学报》2004年第8期734-736,共3页Journal of the Fourth Military Medical University

基　　金：国家自然科学基金资助项目 (39970 652 ) ;国家自然科学基金资助重点课题 (30 2 30 32 0 )

摘　　要：目的 :了解发生乙型肝炎病毒 (HBV)宫内感染的婴儿的转归情况 .方法 :对 4 0 2名HBsAg阳性母亲的婴儿的宫内感染等情况进行远期随访 .所有随访到的母亲和孩子的血清检测肝功能和HBV标志物 .结果 :随访到 5 9对母亲和孩子 .5 9例HBsAg阳性孕妇所生婴儿中 ,出生时 5例HBsAg阳性 ,其中 3例HBsAg持续阳性 ,且这 3例HBsAg持续阳性的儿童全部为HBsAg、HBeAg阳性母亲所生 ;2例HBsAg阴转并产生抗 HBs ;母亲HBV标志物血清学在分娩前后变化明显 .结论 :母亲HBeAg阳性是婴儿发生HBV宫内传播的主要危险因素 ,尤其是孕妇既往HBsAg携带分娩时HBeAg阳性是婴儿发生HBV宫内传播后形成乙肝病毒携带的危险因素 ;婴儿的免疫无应答应判定为宫内感染 ;HBsAg阳性母亲妊娠过程中乙肝加重 。AIM: To observe the long term development of infants with Hepatitis B virus intrauterine infection. METHODS: HBV markers (including HBsAg, anti HBs, HBeAg, anti HBe, anti HBc) in all followed up subjects were detected by enzyme linked immunosorbent assay (ELISA) and the serum alanine transaminase levels were assayed by autoanalyzer. RESULTS: Fifty nine pairs of mothers and children were followed up. Among the 59 children, 5 were sera positive for HBsAg at birth, out of whom, 3 were persistently sera positive for HBsAg, and they were all born from mothers whose sera were positive for HBsAg and HBeAg, the rest 2 became sera negative for HBsAg and positive for anti HBs. Obvious differences were found in the mothers sera HBV markers before and after delivery. CONCLUSION: Serum positivity for HBeAg in mothers blood samples is the most important risk factor of HBV intrauterine infection, and serum positivity for both HBsAg and HBeAg are the risk factor of the childrens chronic HBV infection. Intrauterine infection may be responsible for the nonresponse to the vaccine in infants. HBsAg positive pregnant women may increase the risk of intrauterine infection.

关 键 词：肝炎病毒 乙型 宫内感染 肝炎E抗原 乙型 免疫耐受 

分 类 号：R512.62[医药卫生—内科学]