新生儿外周血及胃液乙肝标志物与宫内感染关系的研究

Relationship of HBeAg and HBsAg in neonatal peripheral serum and gastric aspirates to HBV intrauterine transmission

目的:探讨新生儿外周血及胃液HBeAg,HBsAg等标志物与乙型肝炎病毒宫内感染的关系.方法:连续收集母亲外周血标本和新生儿外周血及胃液标本,ELISA检测HBeAg,HBsAg,PCR方法检测HBV DNA;以ABBOTT试剂检测新生儿HBsAg.采用χ2检验等统计学方法对结果进行统计分析.结果:共收集133例母亲、新生儿血标本和胃液标本.58例胃液HBsAg阳性,9例胃液HBeAg阳性.HBV DNA均阴性,其中发生宫内感染5例.统计学检验显示新生儿外周血HBeAg、胃液HBsAg与乙肝病毒宫内感染有关系,而胃液HBeAg阳性与乙肝病毒宫内感染没有关系(P=0.415).结论:新生儿外周血HBeAg与胃液HBsAg与乙肝病毒宫内感染有关;但是由于所有标本HBV DNA均阴性,尚不支持乙肝病毒宫内感染的胃液途径.

AIM： To estimate the relationship of hepatitis B virus （HBV） intrauterine trarsmission to HBeAg or HBsAg in neonatal peripheral serum or gastric aspirates. METHODS： Gastric samples from neonates and serum samples from both mothers and neonates were consecutively collected and detected with ELISA for HBsAg or HBeAg and with PCR for HBV DNA in gastric samples. Chi square test and Fisher＇s exact test were employed to find out the significance. RESULTS： A total of 133 neonatal gastric aspirates were collected and 58 of them were detected positive for HBsAg, 9 positive for HBeAg. All were detected negative for HBV DNA, 5 had intrauterine infection. Statistical analysis indicated that association of HBsAg in gastric aspirates, HBeAg in peripheral serum with HBV intrauterine transmission was significant, but HBeAg in gastric aspirates was not. CONCLUSION： Although HBsAg in gastric aspirates and HBeAg in peripheral serum are associated with HBV intrauterine transmission, HBV DNA was not found in gastric aspirates. Therefore, neonatal acquired HBV by gastric fluid routine is not conclusive.