妊娠晚期人类小DNA病毒B19感染情况,母婴传播及与早产或小于胎龄儿关系的研究

为了解妊娠晚期人类小ＤＮＡ病毒Ｂ１９（ＨＰＶＢ１９）感染情况、母婴传播及与早产或小于胎龄儿的关系，将１０４例母亲及其新生儿分成两组，试验组包括１９例早产儿、３２例小于胎龄儿及其母亲；对照组包括５３例正常新生儿及其母亲。采用聚合酶链反应技术（ＰＣＲ）检测母血、脐血和胎盘组织ＨＰＶＢ１９ＤＮＡ；用鼠抗Ｂ１９单克隆抗体和Ｂ１９联合抗原（ＶＰ１＋ＶＰ２）建立了捕获式ＥＬＩＳＡ法检测母血和脐血ＨＰＶＢ１９特异性ＩｇＭ抗体。结果：１０４例母血中，ＨＰＶＢ１９ＩｇＭ阳性２例（１．９％），１０４例脐血中阳性３例（２．９％）。在母血、脐血及胎盘组织各１０４例中检出ＨＰＶＢ１９ＤＮＡ阳性分别为６例、４例、６例。因此试验组５１对母婴共１０２例中６例有ＨＰＶＢ１９感染（５．９％）；对照组５３对母婴共１０６例中２例有ＨＰＶＢ１９感染（１．９％）。两组Ｂ１９感染率差异无显著意义。提示：在北京地区，妊娠晚期存在Ｂ１９急性感染，应引起重视；Ｂ１９感染与早产或小于胎龄儿的发生可能不相关；新生儿Ｂ１９感染是通过胎盘传播的。对有Ｂ１９感染证据的新生儿进行随访及研究如何阻止胎盘传播很重要。     

宫内感染HBV婴儿接种乙肝疫苗免疫失败的机理和预后研究

为了解宫内受乙型肝炎（简称乙肝）病毒（ＨＢＶ）感染婴儿接种乙肝疫苗导致免疫失败的机理和预后，用植物血凝素（ＰＨＡ）作淋巴细胞增殖试验，用ＨＢＶ前Ｓ２多肽特异性扩增ＨＢＶＤＮＡＳ区基因并分析其变异情况。对４９７名携带ＨＢＶ母亲所生新生儿单纯接种乙肝疫苗，并对携带ＨＢＶ母亲产前注射免疫球蛋白（ＨＢＩＧ）（妇产组）；对携带ＨＢＶ产前不注射ＨＢＩＧ母亲所生４９０名新生儿生后注射ＨＢＩＧ加乙肝疫苗（中山组）。两组均随访４～６年。结果显示，妇产组ＨＢＶ的宫内感染率为１４．３％，中山组ＨＢＶ的宫内感染率为５．７％；淋巴细胞增殖试验显示宫内感染ＨＢＶ后其细胞免疫功能不足，Ｔ淋巴细胞对ＨＢＶ的特异性刺激源处于免疫耐受状态。孕妇产前多次注射ＨＢＩＧ能有效减少ＨＢＶ的宫内感染；在受宫内ＨＢＶ感染的儿童中存在着乙肝病毒变异，感染变异病毒是接种乙肝疫苗免疫失败的重要原因，并易发展为慢性乙型肝炎     

弓形体,人巨细胞病毒和人微小病毒B19感染对新生儿畸形和生长发 …

探讨弓形体（ＴＯＸＯ）人巨细胞病毒（ＨＣＭＶ）及人微小病毒Ｂ１９（ＨＰ－ＶＢ１９）对新生儿畸形及生长发育的影响。采取聚合酶链反应技术对４２例畸形新生儿进行了ＴＯＸＯ－ＤＮＡ，ＨＣＭＶ－ＤＮＡ和ＨＰＶＢ１９－ＤＮＡ的检测，并对检测阳性与阴性畸形新生儿，用标准差记分法（ＳＤＳ）衡量生长发育。ＰＣＲ检测阳性率为１８／４２（４２．８８％），中枢及心血管系统畸形阳性率为１２／１８（６６．６７％），其他系统畸     

新生儿高胆红素血症与人巨细胞病毒感染的关系

为了解高胆红素血症（简称高胆）新生儿中人巨细胞病毒（ＨＣＭＶ）感染状况。方法：用聚合酶链反应（ＰＣＲ）技术对１２０例１２～２８天高胆新生儿的血、尿进行ＨＣＭＶ－ＤＮＡ序列测定。结果：因出生有窒息史、感染致高胆的新生儿中ＨＣＭＶ－ＤＮＡ阳性率分别为３．１％（１／３２）,８．１％（３／３７）。因高胆入院而找不到任何原因的数生儿占１２０例高胆新生儿的１９．２％,与高胆低出生体重儿的ＨＣＭＹ－ＤＮＡ阳性率     

孕妇乙型肝炎病毒感染与新生儿乙型肝炎基因疫苗免疫效果关系的前瞻性研究

目的探讨孕妇乙型肝炎病毒（ＨＢＶ）感染对新生儿乙型肝炎（简称乙肝）基因疫苗免疫接种效果的影响。方法采用酶联免疫吸附试验（ＥＬＩＳＡ）和聚合酶链反应（ＰＣＲ）法对乙肝基因疫苗免疫效果进行了前瞻性研究。结果在新生儿系列血清中均未检出乙型肝炎病毒（ＨＢＶ）ＤＮＡ和血清学感染标志;对照组和感染组新生儿免疫保护率分别为９３％（２８／３０）和８３％（３９／４７）（χ２＝１．７４,Ｐ＞０．０５）,两组汉族和少数民族间免疫保护率亦无统计学差异（概率法,Ｐ＝０．９８;χ２＝０．１１,Ｐ＞０．０５）。结论随着接种次数的增加,各组两民族抗ＨＢｓ阳转率均呈现出不同程度的升高,分娩时孕妇ＨＢＶ感染状态对新生儿抗ＨＢｓ阳转率可能产生一定程度的影响。     

妊娠晚期人类小DNA病毒B19感染情况母婴传播及与早产或小于胎…

为了解妊娠晚期人类小ＤＮＡ病毒Ｂ１９（ＨＰＶＢ１９）感染情况，母婴传播２及与早产或小于胎儿的关系，将１０４例要及其新生儿分成两组，试验组包括１９是瞳儿、３２例小儿胎龄儿及其母亲，对照组包括５３例正常新生儿及其母亲。采用聚合酶链反应技术（ＰＣＲ）检测母血、脐血和胎盘组织ＨＰＶＢ１９ＤＮＡ；用鼠抗Ｂ１９单克隆抗体和Ｂ１９联合抗原（ＶＰ１＋ＶＰ２）建立了捕获式ＥＬＩＳＡ法检测母血和脐血ＨＰＶＢ１９特异性     

乙肝病毒携带产妇母乳喂养问题的研究

为了探讨忆肝病毒携带产妇母乳喂养的安全性问题，我们收集了７２例ＨＢｓＡｇ阳性产妇的初乳及其新生儿的静脉血，检测其乙肝病毒标志物和ＨＢＶＤＮＡ。发现ＨＢｅＡｇ阳性产妇和ＨＢｅＡｇ阴性产妇初乳的乙肝标志物阳性率分别为７１％和４５％，其新生儿近内感染率分别为２９％和１６％。结论：ＨＢｅＡｇ阳性产妇的乳汁排毒率高，传染性强，不宜哺乳。已发生宫内感染的新生儿母乳喂养利大于弊。尚未感染的新生儿是否喂养母乳要根     

聚合酶链反应对抗—HBc阳性母亲宫内传播乙肝病毒的研究

应用聚合酶反应技术检测１９例抗－ＨＢｃ－阳性，ＨＢｓＡｇ阳性之母婴ＨＢＶＤＮＡ。结果显示，２／６ＨＢｃ阳性母亲１／６抗－ＨＢｃ阴性婴儿，１例抗ＨＢｃ，ＨＢｅＡｇ阳母亲的ＨＢＶＤＮＡ阳性。证实了抗－ＨＢｃ阳性，ＨＢｓＡｇ阴性母亲不仅体内存在ＨＢＶＤＮＡ，而且经过子宫内胎盘传播导致了婴儿的宫内感染，说明不仅ＨＢｓＡｇ阳性母亲，而且ＨＢｓＡｇ阴性但抗－ＨＢｃ阳性母亲同样可引起乙肝的宫内感染，对乙肝母婴传     

戊型肝炎病毒宫内感染及产儿死因研究

目的为了从分子水平探讨孕妇感染戊型肝炎病毒（ＨＥＶ）后胎儿宫内感染和死亡原因。方法对１７例患重症戊型肝炎的孕妇和娩出的１８例新生儿，以酶联免疫吸附法测母血和脐带血抗－ＨＥＶＩｇＭ／ＩｇＧ，同时查新生儿肝组织病理改变，免疫组化法查肝内戊型肝炎病毒抗原（ＨＥＶＡｇ），用地戈辛（ＤＩＧ）探针标记ＨＥＶｃＤＮＡ２３ｑｂｐ片段进行原位杂交查肝内ＨＥＶＲＮＡ。结果母血抗－ＨＥＶ、ＩｇＭ／ＩｇＧ均阳性，脐带血仅抗－ＨＥＶＩｇＧ阳性，肝组织以变性、炎变为主，新生儿肝内ＨＥＶＡｇ阳性率７７％（１０／１３），ＨＥＶ－ＲＮＡ阳性率６２％（８／１３）。结论ＨＥＶ存在宫内感染     

孕妇乙型肝炎病毒感染与新生儿乙型肝炎基因疫苗免疫效果关系的 …

目的 探讨孕妇乙型肝炎病毒（ＨＢＶ）感染对新生儿乙型肝炎（简称乙肝）基因疫苗免疫接种效果的影响。方法 采用酶联免疫吸附试验（ＥＬＩＳＡ）和聚合酶链反应（ＰＣＲ）法对乙肝基因疫苗免疫效果进行了前瞻性研究。结果 在新生儿系列血清中均未检聘书国型肝炎病毒（ＨＢＶ）ＤＮＡ和血清学感染标志；对照组和感染组新生儿免疫保护率分别为９３％（２８／３０）和８３％（３９／４７）（ｘ＾２＝１．７４，Ｐ〉０．０５），两组     

新生儿外周血单个核细胞感染乙型肝炎病毒的机制及意义

目的探讨新生儿外周血单个核细胞（PBMC）感染乙型肝炎病毒（HBV）的机制及意义。方法选择84例HBsAg阳性、HBeAg阴性的孕妇及其分娩的新生儿为研究组。16例HBsAg阴性孕妇及其分娩的新生儿作为对照。ELISA检测新生儿HBV血清学标志物（HBVM）,巢式PCR（n-PCR）检测孕妇及新生儿血清和PBMC中HBV DNA。对血清HBsAg及HBV DNA阴性、仅PBMC中HBV DNA阳性的新生儿随访1年,观察HBsAb产生及PBMC中HBV DNA存在状况。结果（1）84例孕妇血清HBV DNA阳性45例（53．57％）;PBMC中HBV DNA阳性34例（40．48％）,两者相比差异无统计学意义（x^2=2．891,P〉0．05）。血清及PBMC中HBV DNA均为弱阳性。（2）研究组新生儿感染24例（28．57％）。其中仅血清HBV DNA阳性7例,仅PBMC中HBV DNA阳性11例,血清和PBMC中HBV DNA同时阳性6例,血清及PBMC中HBV DNA均为弱阳性;新生儿血清HBsAg均阴性。对照组无新生儿感染。两组新生儿感染差异有统计学意义（x^2=4．55,P〈0．05）。（3）研究组新生儿11例（13．10％）仅PBMC中HBV DNA阳性,均为弱阳性。其母亲仅血清HBV DNA阳性5例,仅PBMC阳性2例,血清及PBMC均阳性4例。对11例中7例仅PBMC中HBV DNA阳性的新生儿随访1年。其中4例血清HBsAb阳性,PBMC中HBV DNA阴性;3例HBsAb阴性,其中2例PBMC中HBV DNA仍为弱阳性。7例血清中HBsAg及HBV DNA均阴性。结论（1）孕妇血清或PBMC中HBV DNA阳性均可导致新生儿PBMC感染。（2）感染了HBV的PBMC可在血清HBsAg和HBV DNA阴性的新生儿体内长期存在,并影响新生儿免疫接种后HBsAb的产生。     

Maternal diabetes and neonatal macrosomia. II. Neonatal anthropometric measurements

Anthropometric measurements were obtained within 12 h of birth in 52 infants of non-diabetic mothers and 61 infants of diabetic mothers. Most of the diabetic patients were under good control, only ten of 61 having postpartum hemoglobin A1c levels in excess of normal. Neonates were grouped as normally-grown or macrosomic. Birthweight, crown-heel length, head circumference and skinfold thickness were measured. In each diabetes class, macrosomic neonates had larger mean length, head circumference and skinfold thickness than their normally-grown peers. At equal birthweight, neonates of gestational diabetic mothers and of non-diabetic mothers were similar in length, head circumference and skinfold thickness. Neonates of permanently insulin-requiring diabetics were similar to their non-diabetic peers in length and head circumference but had thicker skinfold thicknesses. Anthropometric measurements do not permit differentiation of the origin of neonatal macrosomia.     

乙型肝炎病毒宫内感染对新生儿外周血细胞因子干扰素γ和白介素4的影响

目的 探讨乙型肝炎病毒(HBV)侵犯新生儿外周血单个核细胞(PBMC)后,对新生儿免疫功能的影响,了解其免疫失败发生的机理.方法 聚合酶链反应法(PCR)检测67对乙型肝炎表面抗原(HBsAg)、乙型肝炎e抗原(HBeAg)阳性孕妇及其新生儿血清和PBMC的HBV DNA.根据新生儿PBMC中HBV DNA分成阴性和阳性组,将新生儿的PBMC分别在植物血凝素(PHA)和纯化HBsAg刺激下进行体外细胞培养,检测培养上清液中干扰素-γ(IFN-γ)、白介素-4(IL-=4)的分泌含量.结果 (1)35例母亲PBMC HBV DNA阳性者其新生儿15例为阳性,母亲与患儿PBMC HBV DNA阳性,差异有显著统计学意义(P＜0.01).(2)新生儿PBMC内HBV DNA阳性组与阴性组比较,纯化HBsAg刺激时,阳性组IFN-γ的分泌量较阴性组低(P＜0.01),IL-4含量显示PBMC HBV DNA阳性组高于阴性组(P＜0.05),PHA刺激时,两组IFN-γ、IL-4含量差异无统计学意义(P＞0.05).结论 PBMC内的HBV DNA可能是HBV母婴垂直传播的一条重要途径;宫内新生儿PBMC感染HBV,IFN-γ特异性反应低下,而IL-4特异性反应增强,细胞调节失衡,可能是新生儿免疫失败和易于免疫耐受的一个重要原因.     

父婴传播的乙型肝炎病毒C基因变异研究

目的 探讨乙型肝炎病毒(HBV)父婴传播的可能性。方法 选择父亲为HBV携带者而母亲无任何HBV感染标志的新生儿为研究对象,检测新生儿的HBV感染标志,比较父亲与子代所携HBV C基因nt2022～2301段序列同源性。结果 16对父亲与新生儿所携HBVC基因同源性在99％～100％,检出2029、2034、2044、2059、2078、2095、2104、2154、2161、2169、2189、2201、2233、2251、2284、2288、2293位核苷酸变异,其中2189、2288位核苷酸变异为表型变异。2189位点A变C致使C区第97位氨基酸由异亮氨酸变为亮氨酸,2288位点C变A使C区第130位氨基酸由脯氨酸变为苏氨酸,其他位点为无表型变异。6对(37．5％)父亲与新生儿存在上述表型变异。结论 存在HBV的父要传播途径且存在主要变异株。     

婴儿输血传播病毒感染途径的分子病毒学研究

目的　观察产妇和所生婴儿在分娩及母乳喂养 6个月后的输血传播病毒 (TTV)感染情况 ,探讨婴儿TTV感染途径。方法　应用套式PCR对 40 0对正常孕产妇分娩前的血清及其新生儿的脐血血清标本、产妇的乳汁配对进行TTV DNA检测 ,对TTV DNA阳性、坚持母乳喂养的母亲及其婴儿进行 6个月随访 ,克隆其中 13对配对阳性标本的TTV基因 ,通过DNA序列测定比较分析母婴TTV感染株之间的核苷酸序列同源性。结果　 6 2例孕母血清、4例新生儿脐血血清、2 0例母乳TTV DNA阳性 ,TTV阳性母亲的乳汁TTV DNA检出率32 2 % (2 0 / 6 2 )。经 6个月随访孕母血TTV DNA阳性的 42对母乳喂养的母婴 ,母血清TTV DNA阳性率2 1 3 % (9/ 42 ) ,婴儿血清TTV DNA阳性率 40 5 % (17/ 42 ) ,孕母血清TTV DNA阳性的婴儿血TTV DNA由阴转阳率 38 1% (16 / 42 )。配对比较母婴间TTV感染株序列同源性为 97 4%～ 99 8%。结论　孕产妇血清TTV阳性率较正常人高 ,乳腺可能是TT病毒的另一存在部位 ,母乳喂养及母婴间密切接触可能是母 儿间TTV的重要传播途径。     

Perinatal hepatitis B virus infection caused by antihepatitis Be positive maternal mononuclear cells.

To investigate the infectivity of hepatitis B virus (HBV) from mothers to their newborn offspring, HBV-DNA in plasma and peripheral mononuclear cells from 28 antihepatitis Be positive, hepatitis B surface antigen positive carrier mothers was examined by a highly sensitive polymerase chain reaction/Southern hybridisation technique. HBV specific DNA was detected in three maternal mononuclear cell samples, but was absent in plasma. Two of four infants born to the three mothers with HBV-DNA positive mononuclear cells developed acute or fulminant hepatitis within three months after birth. Two infants were effectively prevented from infection with HBV by combined hepatitis B immunoglobulin/HBV vaccine administration. The 25 infants born to the HBV-DNA negative mothers were free of HBV infection within the next seven months to 3.5 years. These results suggest that latent infection with HBV in maternal mononuclear cells is responsible for perinatal HBV infection.     

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目的探讨乙肝病毒表面抗原(HBsAg)阳性孕妇分娩新生儿乙肝病毒标志的临床意义。方法对1999-07—2002-06北京地坛医院儿科996例新生儿生后第3天检测静脉血乙肝病毒标志,追踪观察199例成长到3个月至4岁,将乙肝病毒标志HBsAg和HBeAg进行分析。结果新生儿生后第3天HBsAg和HBeAg阳性率分别为27.2%(271/996)、48.1%(479/996),有495例检测抗-HBc,阳性率高达99.2%(491/495)。在生后3个月至4岁间复测乙肝病毒标志199例,有17例感染乙肝病毒,占8.5%(17/199)。分别比较生后第3天血清HB-sAg、HBeAg滴度,感染乙肝病毒新生儿的HBsAg滴度高于未感染新生儿(P<0.01),而HBeAg滴度水平差异不明显(P>0.05)。将感染、未感染乙肝病毒儿童复查结果与生后第3天血清HBsAg、HBeAg滴度分别进行比较,17例感染乙肝病毒儿童血清HBsAg和HBeAg滴度明显升高(P<0.001,P<0.05),而182例未感染儿童明显减低(P<0.001)。结论HBsAg阳性孕妇分娩新生儿血清HBsAg、HBeAg和抗-HBc阳性不能作为诊断感染乙肝病毒的依据,新生儿血清HBsAg滴度较高并在生后3个月逐渐升高,可以作为儿童感染乙肝病毒的诊断依据。     

Effects of maternal smoking on fetal growth and nutrition.

Standard anthropometric measurements were made on 320 term neonates to investigate the influence of smoking on fetal growth and nutrition. Maternal height and triceps skinfold thickness were also measured. Of 320 infants, 126 (39%) were born to mothers who smoked. Maternal triceps skinfold thickness was significantly smaller in smoking mothers. A correlation existed between maternal and infant triceps skinfold thickness. Measurements of infant growth, birthweight, occipito-frontal circumference, and crown-to-heel length were significantly smaller in infants of smoking mothers and remained significantly smaller when corrections were made for maternal triceps skinfold thickness, height, and social class. While these data do not exclude a nutritional mechanism for the effect of maternal smoking on the fetus, the major growth-retarding effects remain after corrections for this. This reduction in occipito-frontal circumference in infants of smoking mothers, and the possible significance of this is stressed.     

A study of immunoprophylaxis failure and risk factors of hepatitis B virus mother-to-infant transmission

Hepatitis B virus (HBV) infection is of high prevalence in China. Mother-to-infant transmission is the major route for HBV transmission and subsequent chronicity. This study aimed to investigate current HBsAg-positive rate among pregnant women and immunoprophylaxis outcome in China. Multicenter prospective study was conducted in 10 centers. From 2008 to 2012, 67,720 pregnant women were screened and 1,150 HBsAg-carrier mothers and their infants aged 8–12 months were studied in four out of all centers, among whom HBV markers (HBsAg, HBsAb, HBeAg, HBeAb, and HBcAb) and HBV DNA (in three centers) were measured. The results showed that HBsAg-positive rate of pregnant women was 6.7 % (4,533/67,720) and infants’ immunoprophylaxis failure rate was 3.4 % (39/1,150). Immunoprophylaxis failure infants were all born to mothers of HBeAg-positive and HBV DNA ≥6 log₁₀?copies/ml. Among infants of HBeAg-positive mothers, multivariable analyses showed the following: mother’s age <28 years vs ≥28 years, RR?=?0.157, 95 % confidence interval (CI) [0.067, 0.369], p?=?0.000; Neonates receiving vaccine vs vaccine plus hepatitis B immune globulin (HBIG), RR?=?0.371, 95 % CI [0.167, 0.825], p?=?0.015. Pregnant women receiving HBIG in the third trimester, vaginal delivery and breastfeeding had no significant effects on HBV mother-to-infant transmission. Conclusions: Pregnant women are still of high HBsAg prevalence in China. HBV mother-to-infant transmission still occurs after passive-active immunization. Pregnant women of high HBV replication levels are the major risk population of HBV mother-to-infant transmission. Passive-active immunization is necessary for neonates of HBeAg-positive mothers. Mother’s age <28 years and neonate receiving vaccine only were the risk factors for HBV mother-to-infant transmission. Breastfeeding did not put children at risk of mother-to-infant transmission.     

Hepatitis B virus infection in pregnant mothers and its transmission to infants

Screening for serological markers of hepatitis B virus infection was done on 500 pregnant mothers. HBsAg, AntiHBs and HBeAg were done. HBsAg was positive in 3.6%, AntiHBs in 17.4% and HBeAg in 0.4% cases. The infants born to the asymptomatic HBsAg carrier mothers were followed upto 6 months to determine the vertical transmission of HBV infection. Rate of transmission of infection from HBsAg positive mothers to infants were 16.66% irrespective of HBeAg status, whereas it was nearly 100% in case of HBeAg positive mothers. All of the HBsAg positive infants developed the antigenemia between 3–6 months of age, supporting the hypothesis that intrapartum transmission is the major mode of vertical transmission.