母亲血清HBV-DNA载量与新生儿HBV感染率间的相关性分析

Correlation Analysis between Maternal Serum HBV-DNA Load and the Infection Rate of HBV in Newborns

目的探讨分析母亲血清HBV-DNA载量与新生儿HBV感染率间的相关性,以期为乙型肝炎的防治提供理论依据。方法选取2013年1月-2016年5月间在我院住院分娩的516例HBV感染产妇作为研究对象,分别采产妇静脉血及新生儿脐端脐血;荧光实时定量PCR法检测产妇HBV-DNA含量,酶联免疫法检测乙型肝炎血清学标志物;分析母亲血清HBV-DNA载量与新生儿HBV感染率间的相关性。结果新生儿感染HBV的概率随着产妇血清HBV-DNA载量的增加而增加,经相关性分析显示,母亲血清HBV-DNA载量与新生儿HBV感染率间存在正相关(r^2=0.9485,P<0.05);其中大三阳组(200例)有44例新生儿感染HBV病毒,感染率为22.00%;小三阳组(316例)有4例新生儿感染HBV病毒,感染率为1.27%;两组比较差异具有统计学意义(χ~2=62.4099,P<0.05);母亲血清HBsAg含量≥250 IU/ml组(435例)有47例新生儿感染HBV病毒,感染率为10.81%;母亲血清HBsAg含量<250 IU/ml组(81例)有1例新生儿感染HBV病毒,感染率为0.12%;两组比较差异具有统计学意义(χ~2=7.4125,P<0.05)。结论血清HBsAg含量≥250 IU/ml且HBV-DNA载量>106 copies/ml的产妇,其婴儿是母婴传播的高危易感人群,应着重对该类产妇做好产前干预,降低新生儿HBV病毒的感染率。

Objective To explore the correlation between maternal serum HBV-DNA load and the infection rate of HBV in newborns. Methods A total of 516 puerperae with HBV infection from Jan 2013 to May 2016 were selected and taken vein blood of puerperae and neonatal umbilical blood respectively. HBV-DNA levels were detected by FQ-PCR and the serological marker of hepatitis B was tested by ELISA. The correlation between maternal serum HBV-DNA load and the infection rate of HBV in newborns were analyzed. Results The infection rates of newborn increase as the increase of HBV-DNA loading capacity. Correlational analyses showed that the infection rates of newborn was positively associated with HBV-DNA loading capacity （r^2=0.9485, P〈0.05）. In HbsAg＋/eAg＋/cAb＋ group （200 cases）, 44 newborns were infected HBV and the infection rate was 22,00%. In HbsAg＋/eAb＋/cAb＋ group （316 cases）, 4 newborns were infected HBV and the infection rate was 1.27%. There was significant difference in the two groups （χ^2=62.4099, P〈0.05）. 435 cases of maternal serum HBsAg were ≥ 250 IU/ml and the infection rate of newborns was 10.81% （47/435）. 81 cases of maternal serum HBsAg were 〈250 IU/ml and the infection rate of newborns was 0.12% （1/81）. There was significant difference between the two groups （χ^2=7.4125, P〈0.05）. Conclusion If the HBsAg content is greater than or equal to 250 IU/ml and HBV-DNA loading capacity is more than 106 copies/ml in puerperae serum, the children of them will be high risk population to HBV vertical transmission. Better antenatal interventions should be taken in this kind of puerperae to induce the infection rate of HBV in newborns.