孕妇乙型肝炎血清学模式与新生儿宫内感染的相关性分析

Correlation Between Serological Patterns of HBV in Pregnant Women and Intrauterine Infection

目的探讨孕妇乙型肝炎血清学感染模式与新生儿宫内感染的相关性。方法 ELISA法检测孕妇血清乙型肝炎病毒血清学标志物(HBV-M),HBsAg、HBeAg、HBeAb、HBcAb任一项阳性者,荧光定量PCR法检测脐血HBV-DNA。根据HBV-M不同模式将结果分为HBeAg(+)组、HBsAg(+)HBeAg(-)组、HBsAg(-)HBeAg(-)三组,比较各组脐血HBV-DNA阳性检出率及HBV-DNA定量结果。结果 722例受检孕妇中,93例脐血HBV-DNA检出阳性,阳性检出率为12.9%,HBeAg(+)组阳性检出率显著高于其它二组(P<0.001);三组脐血HBV-DNA对数均值分别为(4.85±1.29)、(4.35±0.98)和(3.75±0.40),HBeAg(+)组脐血DNA含量显著高于其它二组(P<0.001)。结论孕妇血清HBeAg(+)者新生儿宫内感染率较高,孕妇血清HBsAg(-)HBeAg(-)者新生儿亦存在宫内感染的可能性。

Objective To explore the correlation between serological patterns of HBV in pregnant women and intrauterine infection. Methods ELISA was used to detect the immunological markers and FQ PCR was used to detect the level of cord blood HBV-DNA.According to serological patterns of HBV,results were divided into three groups： HBeAg（＋）,HBsAg（＋）HBeAg（-）and HBsAg（-）HBeAg（-）group.The positive rates and level of cord blood HBV-DNA were compared in three groups. Results The positive rates of HBV-DNA in cord blood were 30.9%,14.5% and 5.7% in three groups respectively,group with HBeAg positive was significantly higher than group with HBeAg negative.The logarithm of HBV-DNA level were 4.85±1.29, 4.35±0.98,and 3.92±0.55 in three groups respectively,group with HBeAg positive was significantly higher than group with HBeAg negative. Conclusions The incidence of HBV intrauterine infection is relatively high in pregnant women with HBeAg positive,while in pregnant women with HBsAg and HBeAg negative,HBV intrauterine infection is also possible.