HBsAg阳性孕妇血清HBV—DNA含量与胎儿宫内感染关系探讨

Correlative Study on Serum Hepatitis B Virus DNA Level of Gravidas with Mother-to-Infant Transmission

目的探讨孕妇血清HBV-DNA含量与母婴宫内传播的相关性。方法选择住院分娩的HBsAg阳性孕妇，使用荧光定量PCR方法检测孕妇及其新生儿脐血血清中HBV-DNA含量以及乙肝病毒血清标志物。结果新生儿脐带血的HBv．DNA阳性率为18．5％（17／92），高于脐带血HBsAg的阳性率5．4％（5／92）（P〈0．01）；血清HBeAg阳性孕妇其新生儿脐带血HBV-DNA阳性率为41．2％（14／34），高于HBeAg阴性孕妇组的阳性率5．2％（3／58）（P〈0．01）；且胎儿宫内感染率随母亲血清HBV-DNA含量的增加而升高，HBV-DNA含量与胎儿宫内感染率呈正相关（r=9．439，R=0．46，Pd0．01）。结论应用荧光定量聚合酶链反应检测新生儿脐带血HBV-DNA是监测乙型肝炎发生宫内传播的较敏感指标；孕妇血清HBV-DNA高含量是乙型肝炎宫内感染的主要因素之一。

Objective To investigate the relationship between serum hepatitis B virus DNA （HBV-DNA） level of gravida and mother-to-infant transmission. Methods HBV-DNA were quantitatively examined by FQ-PCR in 92 pregnant women detec- ted positive for HBV and their newborns,and serologic HBV markers were detected by enzyme linked immunoadsorbent assay （ELISA）. Results HBV-DNA positive rate of infant umbilical cord blood was 18. 5% （17/92） ,which was significantly higher than HBsAg positive rate 5.4% （5/92） （P〈0. 01）. HBV-DNA positive rate of newborns born to HBeAg （＋） motherwas 41.2% （14/34）, which was significantly higher than those born to HBeAg（-） mother 5. 2% （3/58）（P〈 0.01）;HBV-DNA and intrauterine fetal infection rates were positively correlated. Conclusion Using FQ-PCR to detect HBV-DNA of umbilical cord blood in newborn infants is a sensitive screenmethod inmonitoring intrauterine HBV transmission. High level of HBV-DNA in pregnantwomen is one of the high risk factors of intrauterine HBV transmission and infection.