阻断乙型肝炎病毒母婴宫内传播对血清病毒DNA和转录体的影响

A Preventive Pbservation on the Vertical Transmission of Hepatitis B Virus Demonstrated by Seroassays for Viral Transcripts,DNA and Proteins

目的 进一步探讨不同方法阻断乙型肝炎病毒 (HBV)母婴垂直传播的效果 ,明确携带HBV生育期妇女干预治疗对保护婴儿抗 HBV感染的意义。方法 12 4例HBsAg HBeAg阳性孕妇分成两组 ,乙肝免疫球蛋白与左旋咪唑涂布剂治疗组 6 1例 ,对照组 6 3例。治疗组均在孕 2 6周起开始注射。用ELISA法检测孕妇和新生儿血清中的HBsAg等免疫学标记物 ,,分别用PCR和RT PCR检测血清HBVDNA及全长型和顿挫性转录体。结果 治疗组和对照组新生儿外周血中HBsAg、病毒DNA、全长型和顿挫型病毒转录体的阳性率分别为 8.2 % ,2 1.3% ,3.2 % ,5 4.8%和 33.3% ,6 .3% ,12 .5 % ,6 2 .5 % ,治疗组的前三项指标明显低于对照组 (P <0 .0 1) ,但后一项检测指标差别不显著 (P >0 .0 5 )。结论 携带HBV孕妇于孕晚期给予乙肝免疫球蛋白和左旋咪唑涂布剂联合治疗后 ,婴儿HBsAg ,HBVDNA和全长型转录体携带率明显降低。然而 ,无论治疗组还是对照组 。

Objective To investigate further the preventive effects of different intervention approaches on mother-infant vertical transmission of Hepatitis B virus (HBV).Methods 124 cases chronic HBsAg-carriers in pregnancy were divided into two groups.61 cases received anti-HBV immunoglobulin injections and levamisole liniment since the 26th week of gestation;63 cases did not receive the treatment and were regarded as a reference group.HBV seromarkers,including HBsAg,HBsAb,HBeAg,HBeAb and HBcAb,were examined by ELISA.The viral DNA and different types of transcripts in the sera were detected using PCR and RT-PCR,respectively.Results The seropositivity rates for HBsAg,viral DNA and full-length and trucated transcripts in babies from the treatment and reference groups were 8.2%,21.3%,3.2%,54.8% and 33.3%,6.3%,12.5%,62.5%,respectively.The first threeparameters were lower in the treatment group than those in the reference group,while there was no significancet difference between two groups.Conclusion The intervention therapy with immunoglobulin injections and levamisole liniment during pregnancy seems preventive on the vertical transmission of HBsAg,viral DNA and full-length transcripts,rather than that of the truncated viral transcripts.