免疫细胞化学法检测乙型肝炎产妇分娩的死胎心脏组织乙型肝炎核心抗原的表达

目的 :观察乙型肝炎病毒 ( HBV)通过产妇传播在胎儿心脏组织中表达的情况。方法 :采集 40例乙型肝炎产妇分娩的死胎 ,常规尸检 ,取心脏组织 ,免疫细胞化学法检测乙型肝炎核心抗原 ( HBc Ag) ;回访孕妇产前静脉血 HBV的检测结果 ;采用百分率行 χ2检验。结果 :HBc Ag阳性颗粒在死胎的心内膜及心脏血管中呈点状及灶状分布 ,心肌细胞核不着色。乙型肝炎表面抗原 ( HBs Ag)、乙型肝炎 e抗原 ( HBe Ag)、乙型肝炎核心抗体( HBc Ab)皆为阳性的孕妇较 HBV单项阳性或 HBs Ag、乙型肝炎 e抗体 ( HBe Ab)、HB-c Ab皆为阳性的孕妇分娩的死胎心脏组织中 HBc Ag阳性率明显升高 ( P<0 .0 5) ;HBV单项阳性与 HBs Ag、HBe Ab、HBc Ab皆为阳性的孕妇分娩的死胎心脏组织中 HBc Ag阳性率比较 ,无显著差异 ( P>0 .0 5)。结论 :孕妇静脉血 HBs Ag、HBe Ag、HBc Ab皆为阳性是乙型肝炎病毒通过母婴垂直传播在胎儿心脏组织中表达的高危因素。

Expression of HBcAg in cardiac tissues of the dead fetuses born by mothers associated with hepatitis B by immunocytochemical method

Objective: To study on the expression of HBcAg in cardiac tissues of the dead fetuses born by mother associated with hepatitis B. Methods: 40 dead fetuses born by mothers associated with hepatitis B were collected. HBcAg in heart tissues was detected by immunocytochemical method. The detection of HBV markers in mother blood was performed by ELISA. Results: The HBcAg was mainly detected on the endocardium and cardiac vessels, but the antigen was not detected on the nuclei of cardiac muscular cells. The immunocytochemical positive reaction was found on the surface of the endocardium and cardiac vessels. In order to evaluate the relationship between HBcAg expression rate in cardiac tissues of dead fetuses and mothers' HBV marker. HBV markers were divided into 3 groups: only one of HBV markers was positive(a); HBsAg, HBeAb and HBcAb were positive(b) and HBsAg, HBeAg and HBcAb were positive(c). There were statistically significant differences between(c) and (a) or (b) ( P<0.05 ); but there was no significant difference between (a) and (b) ( P>0.05 ). Conclusion: Hepatitis B with HBcAg, HBeAg and HBcAb positive was the higher risk factor for maternal fetal transmission.