乙型肝炎表面抗原与乙型肝炎e抗原阴性孕妇乙型肝炎病毒宫内感染的研究

Study on intrauterine infection of hepatitis B virus in pregnant women with hepatitis B surface antigen and hepatitis B e antigen negative

目的探讨应用套式PCR方法检测乙型肝炎表面抗原(HBsAg)及乙型肝炎e抗原(HBeAg)阴性孕妇乙型肝炎病毒(HBV)宫内感染的状况。方法选择HBsAg与HBeAg阴性,其他HBV血清标志物阳性孕妇及其新生儿24例作为病例组,同期HBV血清标志物全部阴性孕妇及其新生儿16例作为对照组。采用套式PCR方法检测两组孕妇及其新生儿的血清及外周血单个核细胞(PBMC)中HBVDNA。结果(1)病例组24例孕妇中,血清HBVDNA阳性8例,阳性率为33%;PBMC中HBVDNA阳性10例,阳性率为42%。其中血清与PBMC均阳性3例,总阳性率为63%(15/24)。(2)病例组24个新生儿中,血清HBVDNA阳性3例,阳性率为13%,PBMC中HBVDNA阳性6例,阳性率为25%。其中血清与PBMC均阳性1例,宫内感染率为33%(8/24)。(3)病例组24例孕妇中,血清阴性而PBMC阳性共7例,其新生儿4例发生宫内感染,感染率为4/7。(4)对照组16例孕妇及其新生儿血清及PBMC中HBVDNA全部阴性。结论HBsAg及HBeAg阴性孕妇也可发生HBV宫内感染,采用灵敏度高的套式PCR方法检测孕妇及其新生儿血清及PBMC中HBVDNA,对诊断HBV宫内感染具有重要临床意义。

ObjectiveTo explore the significance of intrauterine infection of hepatitis B virus in pregnant women with hepatitis B surface antigen (HBsAg) and hepatitis B e antigen (HBeAg) negative by nested polymerase chain reaction (PCR). MethodsTwenty-four pregnant women with HBsAg and HBeAg negative but other HBV markers positive together with their infants were included as study group. Sixteen pregnant women with HBV marker negative and their infants were in the control group. HBV DNA in sera and peripheral blood mononuclear cells (PBMCs) of two groups was detected by nested PCR respectively. Results(1)In the study group, the positive rates of HBV DNA of pregnant women were 33% (8/24) in the sera and 42% (10/24) in PBMCs. Three women were detected HBV DNA in both serum and PBMCs. The rate of HBV infection was 63% (15/24); (2)also in the study group, the positive rates of HBV DNA of the infants were 13% (3/24) in the sera and 25% (6/24) in PBMCs. One newborn was detected HBV DNA in both serum and PBMCs, the rate of intrauterine infection of HBV was 33% (8/24); (3) HBV DNA was detected in sera and/or in PBMCs from four newborns of pregnant women with HBV DNA positive only in PBMCs, the positive ratio was 4/7. ConclusionsHBV intrauterine infection is possible in pregnant women with HBsAg and HBeAg negative. Detecting HBV-DNA in sera and PBMCs of pregnant women and their newborns by PCR is important clinical significance.