乙肝病毒宫内感染临床诊断研究

Clinical diagnosis of intrauterine infection of hepatitis B virus

目的探讨乙型肝炎病毒宫内感染的临床诊断条件。方法收集乙肝表面抗原阳性80例孕妇外周血及其新生儿脐带血进行乙肝标志物和乙肝病毒DNA(HBV-DNA)含量检测,6月龄随访检测其中44例大三阳孕妇新生儿外周血乙肝标志物和HBV-DNA含量。结果乙肝表面抗原阳性80例孕妇新生儿脐血HBsAg、HBeAg、HBV-DNA阳性检出率分别为17.50%(14/80)、25.00%(20/80)、15.00%(12/80)。44例大三阳孕妇新生儿出生脐血HBsAg、HBeAg、HBV-DNA阳性检出率分别为31.82%(14/44)、45.45%(20/44)、27.27%(12/44),6月龄外周血为9.09%(4/44)、4.5%(2/44)、6.81%(3/44)。12例HBV-DNA阳性的新生儿均由大三阳且HBV-DNA载量>105copies/mL孕妇所分娩。结论宫内感染率统计应以孕妇传染性的大小分层统计研究,应有统一检测时间及宫内感染的判断指标。新生儿出生脐血HBsAg和(或)HBV-DNA阳性作为宫内感染筛查指标,持续至6月龄HBsAg和(或)HBV-DNA乃阳性可作为宫内感染诊断指标。

Aim To investigate the clinical diagnosis of intrauterine infection of hepatitis B virus. Methods The hepatitis B virus markers and HBV-DNA concentration in 80 HBsAg positive pregnant women and umbilical cord blood serum samples were detected . The Hepatitis B virus markers and HBV-DNA level in the six-month-old newborns positive for HBsAg,HBeAg,HBcAb born by 44 pregnant women were also determined. Results The positivity rate of HBsAg HBeAg,HBV-DNA in umbilical cord blood of the newborns born by the 80 mothers positive for HBsAg were 17.50% （14/ 80）,25.00% （20/80）, 15.00% （12/80）. The positive rate of umbilical cord blood of HBsAg,HBeAg,HBV-DNA in the newbems born by 44 mothers positive for HBsAg,HBeAg,HbcAb were 31.82% （14/44）,45.45%（20/44）,27.27% （12/44） . The level of HBV-DNA in 12 newborn positive for HBV-DNA and born by mother positive for HBsAg, HBeAg, HbcAb was over 105 copies/ml. Conclusion The positive results HBsAg and/or HBV-DNA in umbilical blood of the newborns can be taken as the indicator of intrauterine infection of hepatitis B virus