血清中乙型肝炎病毒转录的检测在母婴垂直传播中的临床意义

Clinical significance of detection of serum hepatitis B virus transcription in maternal and infant vertical transmission

目的探究血清中乙型肝炎病毒转录的检测在母婴垂直传播中的临床意义。方法选择解放军第三〇二医院2014年10月~2016年10月收治的HBV表面抗原(HBs Ag)为阳性的40例产妇及其新生儿作为研究对象,按照HBe Ag阴性/阳性分为HBe Ag阳性组(21例)和HBe Ag阴性组(19例),分别抽取2 m L母亲外周血和新生儿脐静脉血,提取RNA,经过逆转录及RT-PCR扩增,得到乙肝病毒DNA(HBx DNA),全长型病毒转录体(f RNA),顿挫型病毒转录体(tr RNA),利用琼脂糖凝胶电泳显示出产物。结果 HBe Ag阳性组中母体HBx DNA阳性率和f RNA阳性率明显高于HBe Ag阴性组,差异有统计学意义(P<0.05)。根据母体HBx DNA表型分为HBx DNA阳性组和HBx DNA阴性组。HBx DNA阳性组中母体f RNA阳性率、tr RNA阳性率和新生儿tr RNA阳性率高于HBx DNA阴性组,差异有统计学意义(P<0.05)。结论与f RNA、HBx DNA相比,tr RNA更早出现在HBV母婴传播过程中,有利于确定新生儿HBV感染情况,具有一定的辅助诊断价值。

Objective To explore the clinical significance of the test of serum hepatitis B virus transcription in mater- nal-infant vertical transmission. Methods From October 2014 to October 2016, 40 maternity patients with positive- HBV surface antigen （HBsAg） and their newborns in 302th Hospital of PLA were selected. All the patients divided into HBeAg positive group （21 cases） and HBeAg negative group （19 cases） according to the HBeAg negative/positive. 2 mL maternal peripheral blood and newborn navel blood were collected, the RNA was extracted, then the HBx DNA, fRNA, trRNA were got through reverse transcription and RT-PCR amplification, the products were showed by agarose gel electrophoresis. Results The positive rates of HBx DNA and fRNA of maternity patients in the HBeAg positive group were higher than those in the HBeAg negative groups, with statistically significant difference （P 〈 0.05）. Then the cases were divided into HBx DNA positive group and HBx DNA negative group according to the HBx DNA negative/positive. The positive rates of fRNA and trRNA of maternity patients and trRNA of newborns in the HBx DNA positive group were higher than those in the HBx DNA negative groups, with statistically significant difference （P 〈 0.05）. Conclusion TrRNA appeared in the process of mother-to-child transmission of HBV is earlier than fRNA, HBx DNA, which is helpful to determine neonatal HBV infection status, and has a certain auxiliary diagnostic value.