乙型肝炎家庭聚集性感染因素分析

Analysis of the Influential Factors of Familial Clustering of HBV Infection

目的 探讨HBV感染家庭聚集性影响因素。方法 对 174例乙肝患者家庭成员HBV感染状况进行了调查分析。采用ELISA法检测了 174例乙肝患者和 381例家庭成员HBV感染血清学五项指标 ;PCR法检测了 174乙肝患者血清HBVDNA。结果 HBVDNA阳性患者配偶及子女HBV感染率分别为 74 .1%(其中单项抗HBs阳性 4 5 .5 %)和 4 2 .2 %,显著高于阴性组 33.9%(单项抗HBs阳性 2 5 .8%)和 13.9%(P <0 .0 1)。患者感染模式对配偶及子女HBV感染率的影响 ,由高到低依次为 :“135” >“15” >“14 5” >其它模式。母亲为患者 ,其子女HBV感染率 4 8.8%,明显高于父亲为患者其子女的感染率 2 0 .7%(P <0 .0 1) ,特别是“135”模式HBVDNA阳性的母亲 ,其子女HBV感染率达 70 %.结论 血清HBVDNA阳性和“135”模式是HBV感染家庭聚集性的重要危险因素 ;母亲与子女间的HBV传播大于父亲与子女间的传播 ,但父婴传播也应采取相应的阻断措施。

Objective To study the influential factors of family clustering of HBV infection.Methods The current HBV infection status of family members was analyzed in patients with hepatitis B.Serologic markers for HBV were tested with ELISA method in 174 patients with hepatitis B and in 381 family members Serum HBV DNA in 174 patients was detected by PCR. Results The HBV infection rates of spouse and children of HBV DNA-positive patients were 74.1%(single anti-HBs 45.5%) and 42.2%(P<0.01),respectively,significantly higher than 33.9%(single anti-HBs 25.8%) and 13.9%(P<0.01) in HBV DNA-negative patients.The influence of family members' HBV infection in patient infection model was model“135”>“15”>“145”>the other model.Children' HBV infection rate was 48.8% in mother with hepatitis B,whith was higher than 20.7% in father with hepatitis B(P<0.01).Especially in model “135”-HBV DNA-positive mother,70% of their children were infected by HBV.Conclusion Serum positive HBV DNA and model “135” were important risk factors of familial clustering infection.The transmission rates between mother and children were higher than those between farther and children.However,it is also important to enhance immunity against HBV between father and children.