HBV宫内感染的传播途径及其机理的研究

Study on the transmission routes and mechanism of intrauterine infection of hepatitis B virus

目的探讨HBV宫内感染的传播途径及其机理。方法应用PCR技术检测HBV感染孕妇羊水、阴道分泌物、乳汁、脐血中HBV DNA;免疫组织化学技术检测胎盘组织中HBsAg和HBcAg的表达。结果HBsAg、HBeAg、抗HBc阳性孕妇的羊水、阴道分泌物、乳汁、脐血中均检测到了HBV DNA,阳性率分别为48.28%(14/29)、27.59%(8/29)、37.93%(11/29)和24.14%(7/29);健康对照组孕妇的上述样品中均未检出HBV DNA;HBV感染孕妇胎盘组织各层细胞均可表达两种抗原,但阳性细胞数目从母体面到胎儿面逐渐减少,阳性细胞的着色强度逐渐减弱。健康对照组孕妇胎盘组织中未发现HBsAg和HBcAg阳性染色细胞。结论孕妇感染HBV后可通过多种途径传播,而羊水感染是导致胎儿感染的重要传播途径。

Objective To study the transmission routes and mechanism of intrauterine infection of hepatitis B virus （HBV）. Methods HBV DNA was detected in amniotic fluid, vaginal secretion, latex and umbilical blood of HBV in- fected pregnant women by fluorescence quantitative polymerase chain reaction （PCR）. The expression of HBsAg and HB- cAg in placenta tissues was detected with immune histochemistry assay. Results The positive rate of HBV DNA in am- niotic fluid, vaginal secretion, latex and umbilical blood was 48.28%（14/29）, 27.59%（8/29）, 37.93%（11/29）and 24. 14%（7/29）respectively. HBV DNA was not detected in control group. HBsAg and HBcAg expressed positive in every layer of cells of placenta, but the number of positive cells and strength of stain tapered from maternal side to fetal side. HBsAg and HBcAg was not detected in control group. Conclusion HBV can be disseminated by various routes in HBV infected pregnant women. Especially, amniotic fluid is the important one.