孕妇HBV-DNA定量与母婴垂直传播的临床观察

Clinical Observation of Pregnant Woman Quantitative HBV-DNA and Mother to Infant Vertical Transmission

目的:探讨HBV-DNA定量与孕妇母婴阻断后的HBV宫内感染的临床观察。方法:将286例HBs Ag阳性孕妇分为研究组143例,其中乙肝大三阳46例,乙肝小三阳45例,HBs Ag阳性者52例,HBV-DNA定量均高于正常值或几倍不等;对照组143例,其中乙肝大三阳47例,乙肝小三阳50例,HBs Ag阳性者46例,HBV-DNA定量均在正常范围内。两组均于孕28、32、36周分别肌注HBIG 200 IU,采用酶联免疫吸附试验检测两组新生儿的五项指标。结果:研究组、对照组新生儿脐血检测结果 HBs Ag阳性率分别为34.2%、11.2%,两组比较差异有统计学意义(P<0.05);两组大三阳性率分别为10.9%、12.8%,两组比较差异无统计学意义(P>0.05)。结论:HBV-DNA含量均在正常范围内,HBIG能够有效阻断HBs Ag阳性和乙肝小三阳的母婴传播,但不能阻断乙肝大三阳和HBV-DNA定量异常的乙肝小三阳和HBs Ag阳性患者的母婴传播。

Objective：To investigate the clinical observation on HBV intrauterine infection of maternal and child block after the implementation of quantitative HBV-DNA with pregnant women.Method：In this paper,286 cases of HBs Ag positive pregnant women were divided into the study group（n=143）,46 cases of HBs Ag,HBe Ag,and HBc Ab test positive,45 cases of hepatitis B small Sanyang,52 cases of HBs Ag positive,quantitative HBV-DNA was higher than the normal value ora few times ranging from.The control group（n=143）,47 cases of HBs Ag,HBe Ag,and HBc Ab test positive,50 cases of hepatitis B small Sanyang,46 cases of HBs Ag positive,quantitative HBV-DNA were within the normal range.Among them,the study group and the control group were injected with 200 IU of hepatitis B immunoglobulin for 1 injection at 28 th,32th,and 36 th weeks of pregnancy respectively.The samples of cord blood from the newborns were collected and tested for HBs Ag,HBs Ab,HBe Ag,HBe Ab and HBc Ab by El ISA and FQ-PCR.Result：The study group and the control group positive rates of detection results of neonatal cord blood HBs Ag were 34.2%,11.2%,there was significant difference（P〈0.05）.The control group rates of HBs Ag,HBe Ag and HBc Ab test positive were 8.3%,12.8%,there was no significant difference（P〉0.05）.Conclusion：The content of HBV-DNA are in the normal range,HBIG can effectively block mother to child transmission of HBs Ag positive and HBV small sanyang,but not to block mother to child transmission of hepatitis B small three positive and HBs Ag positive hepatitis B patients with HBe Ag and HBV-DNA quantitative abnormalities.