乙型肝炎病毒DNA定量检测对乙型肝炎产妇母乳喂养的临床指导价值

目的探讨乙型肝炎（乙肝）病毒DNA（HBV—DNA）定量检测对乙肝产妇母乳喂养的临床指导价值。方法选择2012年1～lO月检测乙肝表面抗原（HBsAg）阳性（＋）的产妇100例设为研究组，其中大三阳组产妇32例，小三阳组产妇41例，HBsAg（＋），乙肝核心抗体（＋）组产妇27例。选择同期健康产妇100例设为对照组，分别检测各组产妇血清及乳汁中HBV—DNA水平情况，并对结果进行综合分析。结果研究组3个小组产妇血清和乳汁HBV—DNA阳性率均在85．0％以上，明显高于对照组的0．0％，差异均有统计学意义（P〈0．05）；研究组各组产妇血清和乳汁HBV—DNA水平分别两两比较，差异均有统计学意义（P〈0．05）；研究组产妇乳汁HBV—DNA水平与血清HBV—DNA水平呈正相关f相关系数（r）=0．9569，P〈0．05]。结论乙肝产妇产后能否实施母乳喂养与产后产妇血清及初乳中HBV—DNA的水平有关，因此，必须依据检测结果决定喂养方式．以保证婴儿的哺乳安全。

Clinical significance of hepatitis B virus DNA quantitative detection for the breastfeeding of lying-in women with hepatitis B

Objective To explore the clinical significance of hepatitis B virus DNA （HBV-DNA） quantitative detection for the breast feeding of lying-in women with hepatitis B. Methods Totally 100 puerperas with positive hepatitis B surface anti- gen （HBsAg） from January to October 2012 were chosen as experimental group ,which was including 32 cases of big three positive sign, 42 cases of small three positive sign and 27 cases of HBsAg＋/positive hepatitis B core antibody （HBcAb＋） ;contemporaneous- ly, 100 healthy puerperas were selected as control group. The HBV-DNA of the serum and milk in all the groups were determined, and the results were analyzed comprehensively. Results The positive rates of serum and milk in three sub-groups of experimen- tal group were all above 85.0%, which was significantly higher than those in the control group （0.0%） with statistically significant difference （P〈0.05）. Paired-comparison of concentration levels of HBV-DNA in serum and milk in three sub-groups of experimental group had statistically significant difference（P〈0.05 ）. The HBV-DNA level in milk in experimental group was positively related with that in serumcorrelation coefficient （r）=0.956 9 ,P〈0.05]. Conclusion The breastfeeding of lying-in women with hepatitis B is interrelated with the concentration level of HBV-DNA in the serum and milk, so it is necessary to select feeding patterns based on the test results, in order to ensure the safety of infant feeding.