链酶卵白素-生物素法检测乙型肝炎产妇分娩的死胎肝组织中乙型肝炎病毒及其标志物的研究

Study on the detection of hepatitis virus B in the liver tissues of the dead fetus delivered by hepatitis B mothers

目的 探讨乙型肝炎病毒 (HBV)通过产妇传播在胎儿肝组织中表达的高危因素。方法 采集 40例患乙型肝炎的产妇分娩的死胎 ,常规尸检 ,取肝组织 ,链酶卵白素 -生物素法检测HBsAg ;回访孕妇产前静脉血HBV及其标志物的检测结果 ;取百分率行u检验。结果 HBsAg阳性颗粒在肝细胞胞浆内呈弥散分布 ,肝细胞核不着色 ;含HBsAg颗粒的肝细胞胞浆呈弥漫性棕黄色 ,呈点、灶片状分布于肝组织中 ;毛细胆管上皮和管腔内也可见到棕黄色HBsAg颗粒。 40例乙型肝炎产妇分娩的死胎肝组织中HBsAg阳性 2 0例 (5 0 0 0 %) ,其中静脉血HBV :①单项阳性 (两对半任一项阳性 )、②小三阳 [HBsAg(+) ,HBeAb(+) ,HBcAb(+) ]和③大三阳 [HBsAg(+) ,HBeAg(+) ,HBcAb(+) ]的孕妇分娩的死胎肝组织中HBsAg阳性分别为 13例 (13/ 2 7) (4 8 15 %)、1例 (1/5 ) (2 0 0 0 %)、6例 (6 / 8) (75 0 0 %) ,①和③比较差异不显著 (P >0 0 5 ) ;②和①、③比较 ,差异显著 (P <0 0 5 )。结论 死胎肝组织HBsAg表达与孕妇静脉血中HBV标志有关 ;孕妇静脉血HBV大三阳 [HBsAg(+) ,HBeAg(+) ,HBcAb(+) ]是乙型肝炎病毒通过母婴传播在胎儿肝组织中表达的高危因素。

Objective To analyse the risk factors of the expression of hepatitis B virus in the liver tissue of dead fetus by maternal fetal transmission.Methods 40 liver tissues of the dead fetus were detected HBsAg by immunocytochemistry(SP).HBsAg in the mother veins before delivery was analysed retrospectively.Results HBsAg mainly in the liver cytoplasma could be detected,not in the nuclei,but they were also in the lumens and epithelium cytoplasma of bile capillaries.The positive cells were single or in clusters distributed over the liver tissues.There were 20/40(50\^00%)cases with HBsAg positive in the liver tissues of dead fetus.Among mothers with①{one of the HBV mark(+)},②{HBsAg(+),HBeAb(+),HBcAb(+)} and ③{HBsAg(+),HBeAg(+),HBcAb(+)} before delivery,the dead fetus with HBsAg positive in liver tissues in above 3 groups was 13/27 (48.15%),1/5 (20.00%) and 6/8 (75.00%),respectively.The comparison between ① and ③ were not statistically significant(P>0\^05);But the comparison between ② and ①,③ were statistically significant(P<0\^05).Conclusion The positive express of HBsAg in the liver tissues of the dead fetus is correlated with the HBV in the pregnant women veins.HBV(HBsAg+HBeAg+HBcAb)positive in the mothers veins before delivery is the risk factor for the liver tissue infected by HBsAg from maternal fetal transmission.