死胎肺组织中HBsAg检测的临床和病理研究

Clinical and pathologic study on the detection of HBsAg in the pulmonic tissue of the dead fetus

目的 :观察乙型肝炎病毒通过产妇传播在胎儿肺组织中表达的情况。方法 :采集 40例乙型肝炎产妇娩下的死胎 ,常规尸检 ,取肺组织 ,SP法检测HBsAg ;回访产妇产前静脉血HBV的检测结果。结果 :HBsAg阳性颗粒在死胎的肺泡上皮细胞细胞质、肺血管中及肺泡囊、肺泡管、细支气管表面呈点、灶状分布 ,肺泡上皮细胞核不着色。HBV呈大三阳的产妇较HBV呈单项阳性、小三阳的产妇分娩的死胎肺组织中HBsAg阳性率、肺泡上皮细胞变性、肺羊水栓塞发生率明显升高 ,差异显著 (P <0 .0 5 ) ;HBV呈单项阳性、小三阳的产妇分娩的死胎肺组织中HBsAg阳性率比较 ,差异不显著 (P >0 .0 5 )。结论

Objective To study the express of HBsAg in the pulmonic tissue of the dead fetus infected by HBV by maternal fetal transmission.Methods Pulmonic tissue of 40 dead fetus deherated by puerpera with hepatitis virus B was co^llected.To detect HBsAg by immunocytochemistry(SP).Investigated the results of detection on HBV in the mother veins before deli^very.Results There were HBsAg in the pulmonic tissue.They were mainly on the alveolar sac,alveolar duct,bronchiole and in the alveolar cells plasma,pulmonic vessel.They were not in the alveolar cells nuclei.The positive cells were single or in clusters form distributed over the pulmonic tissue.There were significant difference( P <0.05)for the comparison between the rate of the HBsAg positive express,alveolar cells degeneration and amniotic embolism in the pulmonic tissue of the dead fetus that the puerpera deherated with hepatitis virus B for only one of ①HBVM+,②(HBsAg+HBeAb+HBcAb) and③ ( HBsAg+ HBeAg+HBcAb) in the mother veins before delivery.The difference of the comparison between①and ② was not significant( P >0.05).Conclusion It was the more risk factor of HBsAg express in the pulmonic tissue of the dead fetus infected by HBV by maternal fetal transmission that HBVM(HBsAg+HBeAg+HBcAb)was positive in the mother veins before delivery.