乙肝病毒母婴传播的可能途径研究

The Study of Possible Ways of Materno-infant Transmission of Hepatitis B Virus

目的研究乙肝病毒（ＨＢＶ）母婴之间的各种传播途径，探讨其可能的防治措施。方法采用ＰＣＲ检测法对５６例孕妇作ＨＢＶ－ＤＮＡ检测，阳性者作为研究组，对其新生儿脐血、母乳汁、母唾液作ＨＢＶ－ＤＮＡ检测，同期５２例孕妇血清ＨＢＶ－ＤＮＡ阴性者作对照组，作同样系列ＨＢＶ－ＤＮＡ检测。结果研究组中脐血、母乳汁、母唾液ＨＢＶ－ＤＮＡ的阳性率分别为４２８６％、３７５０％、１０７１％，而对照组分别为０、１９２％、０（Ｐ值分别为＜００１、＜００１及＜００５）。结论ＨＢＶ母婴传播途径最活跃为胎盘传播，其次为乳汁传播。另外，唾液传播也不容忽视。对于母血ＨＢｓＡｇ阳性的新生儿应采取乙肝疫苗加乙肝免疫球蛋白注射的免疫方案。对于母血ＨＢｅＡｇ阳性的新生儿应终止母乳喂养。

Objective To study the possible ways of materno-infant transmission of hepatitis B virus(HBV)and to investigate the preventive methods of transmission of hepatitis B virus. Methods HBV-DNA in umbilical blood,breast milk and maternal saliva was examined using polymerase chain reaction(PCR)in lying-in women with positive serum HBV-DNA(study group of 56 cases)and negative serum HBV-DNA(control group of 52 cases). Results HBV-DNA positive rates in study group were 4286%,3750%and 1071% in umbilical blood,breast milk and maternal saliva,respectively.While HBV-DNA positive rates in control group were 0,192% and 0 in umbilical blood,breast milk and maternal saliva,respecitvely.The postitive HBV-DNA rates in study group is significantly higher than those in controls(P<001005). Conclusion The most active materno-infant transmission pathway of HBV was placental transmission,followed by milk transmission,and salivary transmission cannot be overlooked.For those women with positive serum HBsAg,their newborns are supposed to undergo HBV vaccination and HBV-specific immunoglobulin injection,while for those mothers with positive HBeAg,maternal milking should be avoided.