死胎脐带组织中HBcAg表达的临床和病理研究

Clinical and Pathological Study on the Express of HBcAg in the Unbilical Cord Tissues of the Stillborn Fetus

目的:观察乙型肝炎病毒是否通过产妇传播在胎儿脐带组织表达。方法:采集40例乙型肝炎产妇产下的死胎,常规尸检,取脐带组织,SP法检测HBcAg,回访婴母产前静脉血HBV的检测结果,取百分率行u检验。结果:HBcAg阳性颗粒在死胎的脐带血管内皮细胞浆、血管中呈点、灶状分布,脐带血管内皮细胞核不着色。静脉血HBV小三阳与HBV单项阳性和大三阳的产妇分娩的死胎脐带组织中HBcAg阳性率比较,差异显著(P<0.05);静脉血HBV单项阳性与大三阳的产妇分娩的死胎脐带组织中HBcAg阳性率比较,差异不显著(P>0.05)。结论:乙型肝炎病毒可以通过胎儿脐带组织血液流动来实现母婴垂直传播,乙型肝炎产妇的脐血HBV感染与孕妇静脉中HBV标志有关。

Objective: To observe if there were the express of HBcAg in the umbilical cord tissue of the stillborn fetus infected by HBV through maternal-fetal transmission. Methods: Umbilical cord tissues from 40 cases of stillborn fetus were selected to detect HBcAg by immunocytochemistry(SP) .To investigate the detection results of HBV in the mother veins blood before partuition Results: There were HBcAg in the umbilical cord tissues. They were mainly on the surface of the umbilical cord vessel and in the plasma of the cord vessel' s endothelial cells. They were not in the cord vessel' s endothelial cells nuclei. The positive cells were single or in clusters form distributed over the surface of the umbilical cord vessel and the plasma of the cord vessel' s endothelial cells. There were 14/25,1/4,7/11 cases in which HBcAg expressed in the umbilical cord tissues of the stillborn fetus infected with hepatitis virus B for only one (1)HBVM+ ,)2((HBcAg + HBeAb+ HBcAb)and (3)(HBcAg + HBeAg+ HBcAb)in the mother veins before parturition. The comparison between (1) and (3) was not statistically significant (P> 0.005), The comparison between (2)and(1), (3) were statistically significant ( P < 0.005) . Conclusion: It comes true that HBV transmit between pregnant woman and fetus with the umbilical cord blood stream. The HBVM in the umbilical cord blood is correlated with the HBVM in the pregnant woman veins.