母胎细胞转运与乙型肝炎病毒宫内感染关系的研究

目的探讨母胎细胞转运与乙型肝炎病毒(HBV)宫内感染的关系。方法用STRPCR、As-PCR及hemi-nPCR技术扩增HBsAg阳性孕妇及其新生儿外周血中胎儿DNA及母亲DNA，通过检测TH01、GSTM1、ACE等位基因确定母．胎细胞转运与胎．母细胞转运。采用巢式病例对照研究方法分析母-胎细胞转运与HBV宫内感染的关系。结果以GSTM1、ACE基因多态性判定母亲源性或胎儿源性等位基因，42对信息病例中有26例新生儿发生了母．胎细胞转运(61．90％，26／42)；40对信息病例中有32例发生了胎-母细胞转运(80．00％，32／40)；10对母胎发生了双向转运。统计分析显示母-胎细胞转运与HBV宫内感染有关联，胎．母细胞转运与HBV宫内感染无关联，母-胎细胞转运与胎-母细胞转运无关。母-胎细胞转运、孕妇PBMC HBV DNA阳性是HBV宫内感染的危险因素，二者未显示交互作用；母-胎细胞转运、孕妇PBMC HBV DNA阳性与新生儿PBMC HBV感染有关，两因素间亦未显示交互作用。结论母胎之间存在细胞转运，母-胎细胞转运是HBV宫内感染的危险因素，这可能是对HBV宫内感染途径的补充。

Study on the relationship between fetomaternal cellular traffic and hepatitis B virus intrauterine infection

Objective To study the relationship between fetomaternal cellular traffic and hepatitis B virus(HBV) intrauterine infection.Methods Maternal DNA and fetal DNA were amplified by short tandem repeat (STR)-polymerase chain reaction(PCR),allele-specific PCR(As-PCR) and heminested PCR(hemi-nPCR). Cell transfer from mother-to-fetus or fetus-to-mother was determined by detecting the existence of TH01,GSTM1 and ACE.The relationship between cell transfer from mother-to-fetus and HBV intrauterine infection was analyzed by nested case-control study. Results 26 of the 42 informative mother-baby pairs indicated mother-to-fetus cell traffic, 32 of the 40 informative mother-baby pairs indicated fetus-to-mother cell traffic and two-way cell traffic occured in 10 mother-baby pairs. Statistical analysis demonstrated that the mother-to-fetus instead of fetus-to-mother cell traffic presented the association with HBV intrauterine infection.There was no significant correlation between mother-to-fetus cell traffic or the fetus-to-mother cell traffic.Both mother-to-fetus cell traffic and PBMC HBV DNA positivity appeared in pregnant women were risk factors of HBV intrauterine infection but the two did not manifest the interaction.The positive risk factors of positivity PBMC HBV DNA in newborns would included mother-to-fetus cell traffic and PBMC HBV DNA in pregnant women, also did not display the interaction.Conclusion The cell traffic from HBsAg positive mother to fetus had more contribution to HBV intrauterine infection, which was possibly one of the HBV routes of intrauterine infecting.