产妇乳汁HBV—DNA与血清HBV—DNA含量相关性

目的探讨乙肝产妇血清中HBV—DNA含量与母乳HBV—DNA含量的关系，以便更好的指导母乳喂养。方法采用实时定量PCR（Real—time quantitative PCR，RQ—PCR）方法，对80例乙肝血清学阳性的产妇血清及乳汁中HBV—DNA定量检测，分析血清HBV—DNA含量和乳汁HBV—DNA含量之间的相关关系。结果80例患者中，60例血清HBV—DNA检测阳性，其中HBV—DNA含量〉1×10^5IU／ml为39例，血清HBV—DNA〉1×10^5IU／ml的39例患者，有30人乳汁中检测到HBV～DNA，阳性率为76．92％，而且乳汁中HBV—DNA含量对数值与血清HBV—DNA含量对数值有正相关关系，相关系数r=0．924（r=0．924）；≤1×10^5IU／ml为21例，血清HBV—DNA≤1×10^5IU／ml的21例患者，乳汁中均未检测到HBV—DNA，乳汁HBV—DNA阳性患者，血清HBeAg（＋）占80％，HBeAg（-）占20％，两组比较，差异有统计学意义（P〈0．01）；两组患者乳汁HBV—DNA含量无显著性差异（P〉0.05）。结论产妇血清与乳汁中HBV—DNA含量具有密切的相关性。而血清中的HBeAg与乳汁中HBV—DNA含量无明显关系，血清中的HBeAg作为产妇哺乳传染性指标，尚有待进一步研究。

Correlation loads of HBV-DNA in breast milk and serum of pregnant Hepatitis B virus carriers

Objective To investigate the relationship between the load of HBV-DNA in serum and breast milk of pregnants HBV carriers. Methods Content of HBV-DNA in serum and breast milk specimens of 80 pregnant women positive for HBsAg were detected by real-time quantitative polymerase chain reaction （RQ-PCR） and the correlation between the load of HBV-DNA in serum and breast milk was analyzed. Results In 80 patients,there were 60 patients with serum HBV-DNA. The HBV-DNA contents in 39 cases was higher than 1×10^5 IU/ml （65.00%） ,while HBV-DNA contents was in 21 cases was less than 1×10^5 IU/ml （35.00%）. HBV-DNA was not detected in the breast milks of 21 patients with serum HBV-DNA less than 1×10^5 IU/ml. In 39 patients which serum HBV-DNA was higher than 1×10^5 IU/ml,the level lof HBV- DNA in in the milk of 30 patients were detected with a positive rate of 76.92%. The logarithm value of HBV-DNA contents between serum and breast milk was positive correlated in patient whose HBV-DNA content was higher than 1×10^5 IU/ml with correlation eoettieient of 0.924. In all patients positive for breast milk HBV-DNA,HBeAg （＋） patients and the HBeAg （-） patients accounted for 80% and 20%, showing significant difference （P〈0.01）. Conclusion The contents of HBV-DNA in serum is well correlated to the contents of HBV-DNA in breast milk of pregnant women. There is no evidence that serum HBeAg is related to breast milk HBV-DNA contents. In guiding the process of breast-feeding, HBeAg in serum can not be detected for the evaluation of the risk of breast-feeding,unless combined with the detection of HBV-DNA in mother＇s breast milk.