乙肝病毒标志物阳性产妇乳汁中乙肝病毒检测结果分析

Detection and analysis of hepatitis B virus in milk of the mothers with positive hepatitis B virus marker

目的 探讨乙肝标志物阳性产妇是否适宜母乳喂养.方法 对87例乙肝病毒标志物阳性产妇的乳汁进行HBV-DNA检测,并对其中64例乳汁同时进行了HBV标志物的检测.结果 87例乙肝病毒标志物阳性产妇中,母乳中HBV-DNA阳性率23.0%,且呈不同病毒携带状态,其乳汁中HBV-DNA阳性率有差异.HBeAg阳性者,乳汁HBV-DNA阳性率为62.5%,明显高于HBeAg阴性者乳汁中HBV-DNA的阳性率7.9%,（χ2=29.226,P=0.000）.87例HBsAg阳性产妇中,血清HBV-DNA阳性者52例,HBV-DNA阴性者35例,血清HBV-DNA阳性者其乳汁HBV-DNA阳性率为36.5%,高于HBV-DNA阴性者乳汁中HBV-DNA的阳性率2.9%,（χ2=13.405,P=0.000）.乳汁HBsAg和HBeAg皆阳性者,其HBV-DNA阳性率为86.7%.乳汁HBsAg阳性组HBV-DNA阳性率55.6%,明显高于乳汁HBsAg阴性组的HBV-DNA阳性率5.4%,（χ2=20.125,P=0.000）.乳汁HBeAg阳性组HBV-DNA阳性率72.2%,明显高于乳汁HBeAg阴性组的HBV-DNA阳性率8.7%,（χ2=23.608,P=0.000）.结论 应将乳汁中HBV-DNA的检测结果作为乙肝病毒标志物阳性的产妇是否适宜母乳喂养的指标,在没有条件进行HBV-DNA检测时,应将乳汁中乙肝病毒标志物的检测结果作为乙肝病毒标志物阳性产妇是否适宜母乳喂养的指标.

Objective To explore whether the mothers with positive hepatitis B virus marker （HBV-M） are suitable for breasffeeding. Methods The milk of 87 mothers with positive HBV-M was detected for HBV-DNA, and HBV-M of 64 of them were detected simultaneously. Results The positive rate of HBV-DNA in milk of mothers with positiveHBV-M was 23.0% with different status of virus carrying, and the positive rate of HBV-DNA was different. The positive rate of HBV-DNA was 62.5% in milk of mother with HBeAg positive, which was higher than that （7.9%） of HBeAg negative mothers （χ2 = 29. 226, P = 0.000 ）. The positive rate of HBV-DNA in milk of mother with positive HBV-DNA was 36.5%, which was higher than that （2.9%） of HBV-DNA negative mothers （χ2 = 13. 405, P =0.000）. The positive rate of HBV-DNA was 86.7% in HBsAg and HBeAg both positive milk. The positive rate of HBV-DNA was 55.6% in milk with HBsAg positive, which was higher than that （5.4%） of HBsAg negative milk （χ2 = 20. 125, P = 0. 000 ）. The positive rate of HBV-DNA in milk with HBeAg positive was 72.2%, which was higher than that （8.7%） of HBeAg negative milk （χ2 = 23. 608,P =0. 000）. Conclusion The detection results of HBV-DNA in milk should be taken as the index of whether the mothers with positive HBV-M are suitable for breastfeeding, and the detection results of HBV-M in milk should be the index if HBV-DNA can not be tested.