新生儿HBV感染率与母亲血清HBV-DNA载量相关性研究

Study on correlation between the infection rate of HBV in newborns and maternal serum HBV-DNA load

目的：研究新生儿乙型肝炎病毒（HBV）感染率与母亲血清 HBV‐DNA载量及乙型肝炎病毒血清学标志物（HBV‐M ）浓度之间的相关性，以指导孕妇孕前准备及孕期处理。方法选取2010年3月－2013年2月慢性乙型肝炎病毒感染产妇及其新生儿各258例，采用荧光定量聚合酶链反应（FQ‐PCR）技术检测母亲血清、新生儿血清 HBV‐DNA载量，采用化学发光微粒子免疫法（CMIA）定量检测乙型肝炎血清学标志物浓度；采用 SPSS 15．0软件对结果进行统计分析。结果产妇血清 HBV‐DNA ＜500 copies／ml 124例，新生儿血清 HBsAg均阴性；产妇血清HBV‐DNA浓度为（500～1．0）×106 copies／ml 45例，新生儿血清 HBsAg 阳性2例；产妇血清HBV‐DNA＞1．0×106 copies／ml 89例，新生儿血清 HBsAg阳性22例；乙型肝炎大三阳产妇的新生儿 HBV感染率为21．8％，乙型肝炎小三阳产妇的新生儿HBV感染率1．3％，差异均有统计学意义（P＜0．05）。结论血清HBeAg阳性且HBV‐DNA载量＞106 copies／ml的 HBV母亲携带，其婴儿是母婴传播的高危易感人群，建议对该类妇女在孕前及孕期进行干预措施，降低血清 HBV‐DNA载量，以减少母婴传播的概率。

OBJECTIVE To study the correlation between the infection rate of HBV in newborns with maternal ser‐um HBV‐DNA load and the concentration of HBV serological markers ,so as to guide the treatment before and during pregnancy .METHODS A total of 258 puerperant with chronic HBV infection and their newborns were selected form Feb .2010 to Mar .2013 ,HBV‐DNA levels in maternal serum and newborns were detected by FQ‐PCR ,the quantities of serological markers of hepatitis B were tested by CMIA .Statistical analysis was made by software SPSS 15 .0 .RESULTS 124 cases of maternal serum HBV‐DNA were ＆lt; 500 copies/ml ,the HBsAg of newborns showed all negative ;a total of 45 cases of maternal serum HBV‐DNA were ranged of 500~1 .0 × 106 copies/ml ,2 newborns showed HBsAg positive ;89 cases of maternal serum HBV‐DNA were ＆gt;1 .0 × 106 copies/ml ,the HBsAg positive rate of newborns serum reached to 24 .7% （22/258） ,the differences of HBV infection rate in newborns serum between 3 groups were significant （P＆lt; 0 .05） .The HBV infection rate of newborns was 21 .8% in HBsAg , HBeAg , HBcAb positive mother ,and it was 1 .3% in HBsAg , HBeAb , HBcAb positive mother ,the difference was significant （P＆lt;0 .05） .CONCLUSION If the HBeAg is positive and HBV‐DNA loading capacity is more than 106 copies/ml in pregnant women serum ,the children of them will be high risk population to HBV vertical transmission .Intervention before or during pregnancy on those pregnant women are recommended to decreased serum HBV‐DNA copies ,in order to reduce the risk of mother‐infant transmission .