胎儿宫内感染乙型肝炎病毒的实验研究(英文)

Laboratory study on intrauterine infection of hepatitis B virus

目的 探讨胎儿宫内乙型肝炎病毒 (HBVDNA)感染的实验诊断方法及其临床意义。方法 应用酶联免疫吸附试验 (ELISA)和荧光定量聚合酶链反应 (FQ -PCR)对 15 6例乙肝表面抗原 (HBsAg)阳性孕妇的母血和产后婴儿脐血及婴儿外周血的乙型肝炎血清学标志物 (HBV -M)和HBVDNA进行检测。结果 15 6例HDsag阳性孕妇所生婴儿脐血和婴儿外周血HBsAg的检出率为 8.3% (13/ 15 6 )、6 .4 (10 / 15 6 ) ,HBeAg检出率分别为 7.1% (11/ 15 6 )、5 .1% (8/ 15 6 ) ,母血、脐血、婴儿外周血HBVDNA阳性检出率分别为 36 .5 % (5 7/ 15 6 )、2 8.2 % (44 / 15 6 )、2 3.7% (37/ 15 6 ) ;5 7例HBVDNA阳性孕妇血病毒含量 (拷贝数 /ml的对数值 )为 7.34± 2 .2 8,37例阳性婴儿外周血HBVDNA含量为 6 .0 8± 0 .96 ;与婴儿外周血检测结果相比较 ,脐血中HBsag、HBeAg的阳性率不仅存在 2 3.1%和 37.5 %的假阳性 ,HBVDNA也存在 16 .7% (7/ 4 2 )的假阳性 ;在HBeAg或HBVDNA阳性孕妇中 ,婴儿外周血HBVDNA的检出率分别为 73.8% (31/ 4 2 )、6 4 .9% (37/ 5 7) ,显著高于HBeAg或HBVDNA阴性者 5 .3% (6 / 114 ) ,(P <0 .0 1) ;婴儿外周血中HBVDNA阳性率随孕妇HBVDNA含量增加而显著增加(P <0 .0 0 5 ) ,其HBVDNA的含量与母血呈正相关 ,(r

Objective:To explore the laboratory diagnostic methods in fetuses HBV infection and the cl inical significance.Methods: Serologic HBV marks (HBVM) and HBV DNA in blood of 156 HBsAg(+) pregnant women ,cord blood and peripheral blood of neonates were detected by enzyme linked immunoadsorbent assay (ELISA) and fiuor esent quantitative polymerase chain reaction (FQ-PCR). Results:H BsAg positive rate of cord blood and peripheral blood of the infants was 8.3% (1 3/156),6.4% (10/156),HBeAg positive rate was 7.1% (11/156), 5.1% (8/156) resp ectively. HBV DNA positive rate was 36.5% (57/156) in maternal blood,28.2% (44/1 56) in cord blood,23.7% (37/156) in infants blood .57 HBV DNA load of maternal b lood was (7.34±2.28),37 infants blood was (6.08±0.96),their HBV DNA were all p ositive;Comparing with peripheral venous blood sample,HBsAg and HBeAg in cord b lood existed false positive,HBV DNA existed 16.7% (7/42) false positive rate too ;When HBeAg(+) or HBV DNA(+) in mothers blood ,HBV DNA positive rate of their i nfants blood was 73.8% (31/42),64.9% (37/57) respectively,which was significantl y higher than mothers w ith HBeAg(-) or HBV DNA(-) ( P <0.01) .and it increased when HBV DNA load in mothers blood was increase d ( P <0.05),their HBV DNA load was positive correlated (r=0.39).Concl usions: Cord blood may be impured by maternal blood,so detection of infa nts peripheral blood is with significance of making correct diagnosis;HBV DNA qu antitative detection is regarded as a most direct,sensitive way in diagnosis of fetuese infection;HBeAg(+) or HBV DNA(+) in mothers is one of the high risk fact ors of intrauterine infection.