HBsAg阳性孕妇宫内感染相关因素研究

Study of intrauterine infections in HBsAg positive pregnant women

目的通过检测HBsAg阳性孕妇的血清乙型肝炎病毒标志物、HBV-DNA及所产新生儿脐血清HBV-DNA,探讨孕妇乙型肝炎感染状况与新生儿宫内感染的关系。方法采用ELISA方法检测181例HBsAg阳性的孕妇血清乙型肝炎病毒标志物,用Realtime-PCR方法检测孕妇静脉血和新生儿脐血清HBV-DNA。结果大三阳和小三阳孕妇分别占18.78%和70.72%,大三阳组孕妇血清和脐血清HBV-DNA阳性率分别为88.24%和50.00%,均明显高于小三阳组的39.06%和1.56%;血清HBeAg阳性组孕妇血清和脐血清HBV-DNA阳性率为89.12%和48.65%,高于阴性组的38.19%和1.39%;母血HBV-DNA高浓度(>1.00E+07)拷贝/ml组脐血清HBV-DNA阳性率为77.78%,高于中浓度(1.00E+03～1.00E+07)拷贝/ml和低浓度(<1.00E+03)拷贝/ml的7.14%。结论血清HBeAg以及HBV-DNA可作为孕妇宫内感染率的预测指标。

OBJECTIVE To explore the correlation between the hepatitis B virus infections in pregnant women and the intrauterine infections through the detection of serum hepatitis B virus markers,HBV-DNA in HBsAg positive pregnant women and cord blood HBV-DNA in newborns.METHODS A total of 181 cases of HBsAg positive pregnant women were collected,the hepatitis B virus serum markers were detected by ELISA,and the HBV-DNA in the vein blood of the pregnant women and the cord blood serum of the newborns were detected by Realtime-PCR.RESULTS The HBsAg（＋）HBeAb（＋）HBcAb（＋） and HBsAg（＋）HBeAg（＋）HBcAb（＋） pregnant women accounted for 70.72% and 18.78%,respectively.The HBV-DNA positive rates in vein blood and cord blood of the HBsAg（＋）HBeAg（＋）HBcAb（＋） group were 88.24% and 50.00%,significantly higher than 39.06% and 1.56% of the HBsAg（＋）HBeAb（＋）HBcAb（＋） group.The positive rates of HBV-DNA in the serum of the pregnant women with HBeAg positive and the cord blood serum of the newborns were 89.12% and 48.65%,higher than 38.19% and 1.39% of the HBeAg negative group.The positive rate of HBV-DNA in cord blood serum of the pregnant women with high concentration of HBV-DNA（higher than 1.00E＋07 copies/ml） group was 77.78%,higher than 7.14% of the medium concentration of HBV-DNA（1.00E＋03-1.00E＋07 copies/ml） and 7.14% of the low concentration of HBV-DNA（lower than 1.00E＋03 copies/ml） group.CONCLUSION Serum HBeAg and HBV-DNA can be used as the indicators for the prognosis of the intrauterine infections in the pregnant women.