乙型肝炎病毒父婴垂直传播的临床研究

Paternal-fetal vertical transmission of hepatitis B virus:a clinical investigation

目的:观察乙型肝炎病毒(HBV)父婴垂直传播的几率。方法:选取2009年3月至2010年3月在广州市番禺区何贤纪念医院正规产检并且分娩的120例HBsAg和HBeAg均为阴性的孕妇作为研究对象,其中60例配偶为乙型肝炎病毒携带者作为研究组,60例配偶HBsAg和HBeAg均为阴性者作为对照组。ELISA和FQ-PCR法分别检测新生儿脐血中HBV-M和HBV-DNA情况。结果:两组新生儿的脐血HBsAg、HBeAg及HBV-DNA阳性率均为0(P>0.05)。研究组和对照组HBsAb(+)孕妇分别为54例和52例,其新生儿脐血中HBsAb(+)者分别为51例和46例,两组比较,差异无统计学意义(P>0.05)。无论研究组丈夫HBV-DNA的含量高低,新生儿脐血中HBV-DNA均为阴性,研究组和对照组HBV父婴垂直传播几率均为0(P>0.05)。结论:在全民普遍接种乙型肝炎疫苗,人群HBsAb阳性率较高的情况下,乙型肝炎病毒父婴垂直传播的几率非常小。

Objective：To study the probability of paternal-fetal vertical transmission of hepatitis B virus （HBV）. Methods： We enrolled 120 pregnant women who tested negatively to both HBsAg and HBeAg and underwent formal examination and delivery in the department of obstetrics and gynecology, Panyu Hexian Memorial Hospital, between March 2009 and March 2010. The 60 patients whose spouses were HBV carriers were assigned to the study group and the remaining 60 cases whose spouses assayed negatively to HBsAg and HBeAg served as the control group. Enzyme-linked immunosorbent assay and fluoresecnt quantitative-polymerase chain reaction were employed to detect the presence of HBV-M and HBV-DNA in the umbilical cord blood. Results： The positive rate of 0% was noted for HBsAg, HBeAg and HBV-DNA in the umbilical cord blood in both groups （ both P 〉 0.05 ）. The positive rates of HBsAb in pragnant women （ 54 vs. 52 ） and umbilical cord blood （51 vs. 46 ） did not differ significantly between the two groups （ both P 〉 0.05 ）. All neonatals tested negatively to HBV-DNA in umbilical cord blood and the probability was 0% for paternal-fetal vertical trasnmission of HBV in both groups （ both P 〉 0. 05 ）, regardless of the copies of parental HBV-DNA. Conlusion： The probability of paternal-fetal vertical transmission of HBV appears rare despite the comparatively high incidence of HbsAb and universal inoculation of HBV vaccine in the population.