胎盘HBV-DNA定量检测与宫内感染关系的研究

Relationship between detection of HBV - DNA in placenta and the intrauterine infection

目的探讨胎盘HBV-DNA含量与宫内感染的关系及作为胎盘传染性和病毒复制的直接指标的可靠性。方法采用FQ-PCR(荧光探针定量聚合酶链反应)检测344例HBV标志物阳性孕妇足月分娩后的胎盘的 HBV-DNA含量,并分别检测同一孕妇分娩前的外周血及脐血的HBV-DNA含量,比较其测定值范围及相互关系。结果 344例孕妇按乙肝标志物组合,分为三组,分别检测分娩前外周血HBV-DNA、胎盘HBV-DNA及脐血HBV-DNA,检出率分别为:(1)HbsAg携带组90例,22．2％(20/90)、33．3％(30/90)和5．6％(5/90);(2)大三阳组134例,70．9％(95/134)、85．8％(115/134)和11．9％(16/134);(3)小三阳组120例,20．8％(25/120)、20．8％(25/ 120)和3．3％(4/120)。孕妇乙肝标志物阳性以大三阳组HBV-DNA阳性率最高,胎盘组织HBV-DNA含量与母血HBV-DNA含量有一致性和相关性。结论外周血HBV-DNA阳性孕妇更易发生胎盘感染。宫内感染的程度可随胎盘组织HBV-DNA含量增加而程度加重。胎盘HBV-DNA含量可作为一个宫内感染的判断指标。

Objective： To investigate the relationship between the intrauterine infection and HBV- DNA level in plaeenta. Methods： According to the results of HBV- Markers all 344 pregnaant women were divided into 3 groups and HBV - DNA level was detected by FQ- PCR （Fish quantity- Polymerase chain reaction）. Results： （ 1 ） In the HBsAg positive pregnant women ： vein blood was 22.2 % （20190）, placenta 33.3 % （ 30/90 ） and umbilical cord blood 5.6 % （ 5/90 ） in 90 HBV-DNA positive; （2）HBeAg positive pregnant women： vein blood was 70.9% （95/134）, placenta 85.8% （115/ 134 ） and umbilical cord blood 11.9 % （ 16/134 ） in 134 HBV - DNA positive134 HBV - DNA positive; （3） HBeAb positire pregnant women： vein blood was 20.8% （25/120）, placenta 20.8% （25/120）and umbilical cord blood 3.3% （4/ 120）. HBeAg HBV- DNA positive group was significantly higher than the other two groups in both vein blood and placenta. Conclusion. This data suggest that the level of HBV - DNA in placenta has positive relation to HBV - DNA in vein blood of pregnant women. With the increase of HBV -DNA level in the placenta, the risk of intrauterine infection increases. The intrauterine infection is associated with high level HBV DNA of palcenta which is one of the important factors.