乙肝病毒宫内传播与胎盘感染的关系

目的：母亲乙肝病毒（ＨＢＶ）感染在宫内即可造成其胎儿感染，但其机理尚不清楚，作者试图了解胎盘细胞中ＨＢＶ的感染情况，宫内传播的危险因素和母胎传播的可能途径。

The relationship between placenta infection and in-trauterine transmission of HBV

Maternal hepatitis B virus (HBV) infection can cause fetal infection in utero, but its mechanism is not clear. This paper tries to show the presence of HBV in pla-cental cells exposed to HBV during pregnancy, the risk factors of intrauterine infection and to trace the possible transmission route from mother to fetus. Methods: ELISA, PCR and ABC immunohistochemical staining with monoclonal anti-HBs and anti-HBc antibodies are used for detection of HBV infection markers in serum and placenta. Case control study is used for analysis of risk factors. Results: The intrauterine infection rate among the infants of 101 HBsAg-positive mothers was 7. 9%(8/101). The intrauterine infection rate among the infants of maternal HBeAg positive was significantly higher than that of maternal HBeAg negative (X2 = 7. 22, P< 0. 01). HBsAg and/or HBeAg were detected in 40 of 101 placentas of HBsAg-positive mothers. The positive rates in de-ctdual cell (DC), trophoblastic cell (TC), villous stromal cell (VSC) and villous capillary endothelial cell (VCEC) were 36.6% (37/101), 28.7% (29/101), 24.8% (25/101) and 11.9% (12/101), respectively. There is a gradually decrease of HBV infection from maternal side to fetal side of placenta. The ORs of HBV intrauterine infections due to infections of TC, VSC and VCEC of placenta barrier were 9. 13, 11. 68 and 43. 50, respectively. There is an increase trend of the ORs from maternal side to fetal side of placenta. Conclusion: HBV could infect placenta tissue. The risk factors of HBV intrauterine infection are maternal HBeAg positive and infection of placenta barrier. The transplacental transmission of HBV may be a cellular transfer.