乙肝病毒携带产妇乳汁的HBV-DNA研究

目的：研究HBV携带产妇血清、乳汁及脐血中的HBV-DNA含量与其血清HBV标志物之间的关系,探讨HBV携带产妇乳汁的传染性。方法：对207例HBV携带产妇,采用电化学发光方法检测产妇的乙肝五项及采用荧光定量PCR技术检测HBV携带产妇血清、乳汁及脐血中的HBV-DNA含量。结果：125例HBsAg和HBeAg双阳性的产妇,其乳汁HBV-DNA阳性率为9.6%,82例HBsAg阳性但HBeAg阴性的产妇,其乳汁HBV-DNA阳性率为2.4%。两组乳汁HBV-DNA阳性率差异有统计学意义（χ^2=4.027,P=0.045）;血清HBV-DNA〈106 copies/ml的产妇其产妇乳汁及脐血中HBV-DNA均为阴性。血清HBV-DNA≥10^6copies/ml的产妇其乳汁HBV-DNA阳性率为12.5%、其新生儿脐血阳性率为15.17%,与血清HBV-DNA〈10^6copies/ml的产妇相比较差异均有统计学意义（P均〈0.001）。结论：对于HBsAg阳性的产妇,HBsAg和HBeAg双阳性的产妇乳汁传染性高于HBsAg单阳性的产妇,血清HBV-DNA≥106copies/ml的产妇乳汁传染性高于血清HBV-DNA〈106copies/ml的产妇。

Study on HBV DNA in breast milk in pregnant women with HBV carrier

Objective：To study the relationship between the load of HBV-DNA in serum and breast milk and the serum HBV makers of pregnant women with HBV carrier,to explore the infectivity of breast milk in pregnant women with HBV carrier.Methods：A total of 207 pregnant women with HBV carrier and their neonates entered the study.Serum HBVmarkers of the women were detected using electrical chemiluminescence immunoassay,the load of HBV-DNA in serum and breast milk of the women and in umbilical cord blood of the neonates were tested by real-time quantitative polymerase chain reaction.Results：The positive rate of HBV-DNA in breast milk was 9.6% and 2.4% in HBeAg-positive mothers group and HBeAg-negative mothers group,respectively（χ^2=4.027,P=0.045）,the positive rate of HBV-DNA in breast milk was 12.5% and in mothers with HBV-DNA≥10^6 copies/ml and mothers with HBV-DNA106 copies/ml,respectively,the positive rate of HBV-DNA in umbilical cord blood was 15.17% and in neonates born to mothers with HBV-DNA ≥10^6 copies/ml and mothers with HBV-DNA106 copies/ml,respectively（P all〈0.001）.Conclusion：For the pregnant women with HBV carrier,mothers with HBeAg positive or HBV-DNA≥106 copies/ml can increase the infectivity of breast milk.