HBV宫内感染预测指标的探讨

Prediction Indexes of Hepatitis B Virus Intrauterine Infection

【目的】探讨HBsAg阳性孕妇的新生儿乙肝联合免疫前的HBV-M和HBV DNA预测HBV宫内感染的实用价值。【方法】对我院2006年6月至2008年2月间分娩的HBsAg阳性孕妇的420例婴儿,其中新生儿HBsAg或HBV DNA阳性为33例,HBsAg和HBV DNA双阳性共6例,对其满6月龄时进行随访,复查HBV-M以确诊HBV宫内感染。【结果】HBV宫内感染率为0.95%(4/420),新生儿HBsAg或HBV DNA阳性诊断HBV宫内感染的阳性似然比为14.3,而HBsAg和HBV DNA双阳性时诊断宫内感染的阳性似然比为208.3。【结论】HBsAg阳性孕妇的新生儿乙肝联合免疫前的HBsAg和HBV DNA双阳性对HBV宫内感染具有较准确的预测作用,可以作为HBV宫内感染的初步临床诊断。

【Objective】 To investigate the value of HBV-M and HBV DNA of newborns born to HBsAg-positive mother,which were tested before combined immunization of hepatitis B.【Method】 A total of 420 infants born to HBsAg-positive mothers delivered in Obstetric Department of the Third Affiliated Hospital of Sun Yat-Sen University from June 2006 to February 2008 were followed up at least 6 months and rechecked HBV-M to confirm the diagnosis of HBV intrauterine infection,which included 33 HBsAg or HBV DNA positive newborn babies and 6 newborns with both HBsAg seropositive and HBV DNA seropositive.【Result】 HBV intrauterine infection rate was 0.95% .Using newborn both HBsAg positive and HBV DNA positive as diagnostic criterion to diagnose HBV intrauterine infection,the positive likelihood ratio was 208.3,while using newborn HBsAg positive or HBV DNA positive as diagnostic criterion,it was 14.3.【Conclusion】 Newborn both HBsAg positive and HBV DNA positive obtained before combined immunization of hepatitis B may predict HBV intrauterine infection,and it may play as a clinical index of preliminary diagnosis of HBV intrauterine infection.