乙肝病毒携带孕妇血清和乳汁中HBV—DNA定量检测研究

目的探讨HBV携带孕妇血清HBV标志物与血清、乳汁中HBV—DNA含量之间的关系，评价母乳喂养的安全性。方法利用EUSA筛查乙肝五项至少一项阳性的孕妇血清HBV—M．将其分为HBeAg阳性组和HBeAg阴性组共180例。同时应用荧光定量PCR对其血清和乳汁中的HBV—DNA进行检测。结果HBeAg阳性组孕妇的血清和乳汁HBV—DNA阳性率为97．7％（88，90）和62．2％（74／90），HBV—DNA平均载量的对数量为7．32±1．83和4．02±1．21。HBeAg阴性组孕妇的血清和乳汁HBV—DNA阳性率为55．5％（50／90）和13．3％（13／90），HBV—DNA平均载量的对数量为5．62±0．93和3．32±0．51。孕妇血清中HBeAg阳性组其乳汁和血清中HBV—DNA阳性率及病毒载量与HBeAg阴性组差异有统计学意义（P〈0．05）。结论HBV携带孕妇的血清中HBV—DNA载量越高，其乳汁HBV—DNA含量越高；二者高度相关（r=0．932，P〈0．01）。血清HBV载量高的孕妇最好不要进行母乳喂养。

Quatitative determination of load of HBV-DNA in serum and breast milk of pregnant HBV-carrying women

Aim To investigate the correlation of load of hepatitis B virus （HBV） DNA in serum and breast milk of HBV carrying mothers with the safety of breast feeding. Methods There 180 parturients with hepatitis B were selected and divided into two groups： serum HBeAg positive group （n=90） and HBeAg negative group （n=90）. Hepatitis B virus DNA was detected by FQ-PCR. Results HBV-DNA positive rate in serum and breast milk of the HBeAg positive group was 97.7%（88/90）and 62.2% （74/90）,the average concentration of HBV-DNA was 7.32±1.83 and 4.02±1.21. But HBV-DNA positive rate of the serum and breast milk in the HBeAg negative group was 55.5% （50/90）and 13.3%（13/90）,the average concentration of HBV-DNA was 5.62±0.93 and 3.32±0.51. Conclusion The load of HBV DNA in serum of HbeAG positive group is positively correlated with the level of HBV-DNA in breast milk in HbeAg psoitive group. Thus breast feding by pregnants with high load of HBV in serum is not recommeded.