乙型肝炎病毒母婴传播问题探讨

A Study on the Materal-Fetal Transmisson of Hepatitis B Virus

探讨乙型肝炎病毒宫内感染及乳汁感染的母婴传播问题 .用聚合酶链反应 (PCR)技术对 75例 HBs Ag阳性产妇初乳及其新生儿外周血进行 HBV DNA的检测 ;同时应用酶联免疫吸附法(ELISA)测定产妇初乳中乙肝病毒 5项标志物 (HBVM) .结果为 1 ) 75例初乳中 HBV DNA阳性率为 68% ,高于同组新生儿外周血 HBV DNA阳性率 34.67% ,有显著性差异 (P<0 .0 1 ) ;HBVM三项阳性各组二者有显著性差异 (P<0 .0 5) .2 ) HBe Ag阳性者初乳及新生儿外周血 HBV DNA阳性率均高于 HBe Ag阴性者 ,有显著性差异 (P<0 .0 5) .3)用 ELISA测定 75例初乳 HBVM,HBe Ag出现率最高 ,与 HBs Ag、抗 - HBc比较 ,有显著性差异 (P<0 .0 1 ,P<0 .0 5) .表明初乳排毒率高于宫内传染率 ,母婴传播率与母血中

To study on the maternalfetal transmission of hepatitis B virus via uterine and colostrum. Polymerase chain reaction (PCR) was used for detection of HBVDNA in colostrum of 75 HBsAg positive puerperants, blood of their neonates. Five markers of HBV (HBVM) were examined by enzymelinked immunosorbent assay (ELISA) in colostrum. The detective rate of HBVDNA was 68% in colostrum of 75 HBsAg positive puerperant, significantly higher than that was of their neonates whose infection rate was 34.67% in blood (P<0.01).The results were similar when HBsAg, HBeAg and antiHBc or HBsAg, antiHBe and antiHBc were positive simultaneously (P<0.05). In HBeAgpositive puerperant there were significantly higher infection rate of HBV DNA in their colostrum and the blood of their neonates than that in HBeAg negative (P<0.05). Among the HBVM, the rate of HBeAg positive was the highest, which was significantly different from that of HBsAg and anti HBc in the colostrum of 75 cases. Our conclusion is that expelling of toxin rate of colostrum is higher than the rate of intraterine infection and there is positive correlation between maternalfetal transmission rate and HBVM infectivity of pregnant women.