遵义地区孕妇乙型肝炎病毒感染及乙肝五项定量调查研究

Prospective investigation of HBV infection and five quantitative hepatitis B results of pregnant women in Zunyi City

目的调查研究遵义地区孕妇乙型肝炎病毒(HBV)感染及乙肝五项定量,为HBV在母婴传播中的预防提供参考。方法选取2014年1月-2016年6月医院住院孕妇2 648例,以金标法检测HBsAg,HBsAg阳性者采用时间分辨荧光免疫分析技术检测乙肝五项定量,荧光定量PCR法检测HBV-DNA,分析结果。结果 2 648例孕妇中有HBsAg阳性者243例,HBV感染率为9.18%;HBV感染孕妇HBV-DNA检测阳性者134例,阴性109例,阳性构成比为55.14%;HBV感染者以HBsAg+HbeAb+HBcAb阳性者所占比例最高,其次为HBsAg+HBcAb、HBsAg+HBeAg+HBcAb阳性,构成比分别为30.45%、25.93%、17.28%,单纯HBsAg阳性者12例,占4.94%;HBsAg+HBeAg+HBcAb模式42例孕妇HBV-DNA均为阳性,阳性率100.00%,HBsAg+HBeAg、HBsAg+HBeAg+HBeAb+HBcAb、HBsAg+HBeAb、HBsAg+HBcAb、HBsAg+HBeAb+HBcAb、HBsAg+HBsAb模式下HBV-DNA阳性率分别为81.82%、72.73%、71.43%、49.21%、37.84%、8.33%;HBVDNA阳性HBV感染孕妇HBsAg、HBeAg高于HBV-DNA阴性孕妇,HBsAb、HbeAb、HBcAb低于HBV-DNA阴性孕妇,比较差异有统计学意义(P<0.05)。结论遵义地区孕妇中存在一定比例HBV感染,乙肝五项定量能较好反应出HBV复制活跃程度,与HBV-DNA关系密切。

OBJECTIVE To prospective investigation of HBV infection and five quantitative hepatitis B results of pregnant women in Zunyi City,so as to provide a reference for the prevention of HBV in mother-to-child transmission.METHODS A total of 2648 cases of pregnant women with prenatal examination from Jan.2014 to Jun.2016 were selected.HBsAg was detected by gold standard method,five quantitative hepatitis B results were detected by time-resolved fluorescence immunoassay technology,and HBV-DNA was detected by fluorescence quantitative PCR method.RESULTS Totally 2648 cases of pregnant women occurred 243 HBsAg positive cases,with the HBV infection rate of 9.18%.There were 134 cases of positive and 109 cases of negative HBV-DNA in HBsAg positive pregnant women,and the constituent ratio of HBV-DNA positive pregnant women was 55.14%.The order of HBV infection pregnant women were：HBsAg＋HbeAb＋HBcAb,HBsAg＋HBcAb,HBsAg＋HBeAg＋HBcAb,and pure HBsAg positive,accounting for 30.45%,25.93%,17.28%and 4.94%,respectively.HBV-DNA were positive in 42 cases of HBsAg＋HBeAg＋HBcAb positive pregnant women,with the positive rate of 100.00%,and the HBV-DNA positive rates of HBsAg＋ HBeAg,HBsAg＋ HBeAg＋ HBeAb＋ HBcAb,HBsAg＋HBeAb,HBsAg＋HBcAb,HBsAg＋HBeAb＋HBcAb,and HBsAg＋HBsAb were 81.82%,72.73%,71.43%,49.21%,37.84%,and 8.33%,respectively.HBsAg and HBeAg infection of HBV-DNA positive pregnant women were higher than those of HBV-DNA negative pregnant women,HBsAb,HbeAb and HBcAb infection of HBVDNA positive pregnant women were lower than those of HBV-DNA negative pregnant women,and the differences were statistically significant（P〈0.05）.CONCLUSIONThere is a certain proportion of HBV infection in pregnant women in Zunyi City,and five quantitative hepatitis B results can reflect HBV replication activity,which is closely associated with HBV-DNA.