HBsAg阳性孕妇足月分娩胎盘HBV感染状态的免疫组织化学研究

目的：拟从观察胎盘乙型肝炎病毒（ＨＢＶ）感染状态，探讨ＨＢＶ宫内传播发生的机制，以期为进一步预防ＨＢＶ宫内传播提供科学依据．方法：采用ＡＢＣ免疫组织化学染色检测ＨＢｓＡｇ阳性孕妇足月分娩胎盘ＨＢｓＡｇ和ＨＢｃＡｇ感染和分布状态．结果：在６２例足月分娩胎盘中，２１例检出了ＨＢｓＡｇ，８例检出ＨＢｃＡｇ．ＨＢｓＡｇ主要分布于蜕膜血管内皮细胞（１８例）、蜕膜细胞（２１例）、滋养层细胞（８例）、绒毛间质细胞（８例）和绒毛血管内皮细胞（５例）的胞浆和绒毛间隙（２１例）中．ＨＢｃＡｇ分布于蜕膜细胞（５例）、蜕膜血管内皮细胞（８例）和绒毛间质细胞（８例）的胞核内．结论：结果提示，ＨＢＶ可在胎盘组织中复制．ＨＢＶ经胎盘感染胎儿的主要途径可能是经血和（或）细胞传递方式实现的．即ＨＢＶ经蜕膜细胞和（或）绒毛间感染滋养层细胞，然后感染绒毛间质细胞，最终感染胎儿毛细血管内皮细胞

Immunohistochemical evidence of HBV infecting placentas of HBsAg positive mothers

Objective: This paper tries to show the presence of HBV infected placental cells exposed to HBV during pregnance and to trace the possible transmission route from mother to fetus. Methods: ABC immunohistochemical staining was employed to detect HBsAg and HBcAg infection and distribution condition in term placentas of HBsAg positive mothers. Results: HBsAg as well as HBcAg were detected in 21 of 62 term placentas of HBsAg positive mothers. The HBsAg was located in the intervillous space (21 placentas) and the cytoplasm of decidua vascular endothelial (18 placentas), decidua (21 placentas), trophoblastic (8 placentas), villous stroma (8 placentas) and villous vascular endothelial cells (5 placentas). The HBcAg was located in the nuclear of decidua cells (5 placentas), decidua vascular endothelial cells (8 placentas) and villous stroma cells (8 placentas). Conclusions: These data suggest that HBV may replicate in placenta. The transplacental mode of HBV may be a harmatogenous cellular route from maternal intervillous space and/or decidua cell to trophoblastic cell, then to villous stromal and endothelial cell.