乙肝产妇HBV-DNA载量与母婴垂直传播之间关系的研究

目的探讨乙肝产妇HBV-DNA载量与母婴垂直传播之间关系,为产前阻断提供可靠依据。方法采用实时荧光定量PCR对174例乙肝孕妇血清中HBV-DNA含量进行检测,同时运用ELISA方法检测婴儿脐带血中HBsAg,并根据HBVDNA载量的不同分为3组进行比较,HBV-DNA阳性分为两组进行产前阻断。结果在受检的174例标本中,HBV-DNA载量小于或等于5.0×102 copies/mL的产妇60例（HBV-DNA阴性）,宫内感染的阳性率为6.67%（4/60）;HBV-DNA载量：〉5.0×102~1.0×106 copies/mL产妇45例,宫内感染的阳性率为13.33%（6/45）;HBV-DNA载量大于1.0×106 copies/mL的产妇69例,宫内感染的阳性率为78.26%（54/69）,HBV-DNA阳性的产妇宫内感染高于HBV-DNA阴性的产妇,组间比较差异有统计学意义（χ2=35.72,P〈0.01）,HBV-DNA载量：〉5.0×102~1.0×106copies/mL和HBV-DNA载量大于1.0×106copies/mL两组产妇之间宫内感染阳性率比较差异有统计学意义（χ2=63.95,P〈0.01）;114例HBV-DNA阳性产妇中,阻断组宫内感染的阳性率为8.22%（6/73）,对照组宫内感染的阳性率为31.73%（13/41）,阻断组和对照组的宫内感染阳性率比较,差异有统计学意义（χ2=10.43,P〈0.01）。结论乙肝孕妇的HBV-DNA载量与母婴垂直传播呈正相关,通过产前阻断可以降低母婴间垂直传播。

The relationship between HBV-DNA capacity in hepatitis B puerpera and mother-to-child vertical transmission

Objective To investigate the relationship between HBV-DNA capacity in Hepatitis B puerpera and Mother-to-child vertical transmission,and provide reliable basis for prenatal blockade.Methods A total of 174samples of HBV-DNA content in Hepatitis B pregnant serum were detected using real-time fluorescent quantitative PCR,and HbsAg in baby umbilical cord blood were detected using ELISA method at the same time,according to the difference between HBV-DNA capacity,three groups were,divided and compared,HBV-DNA positive were divided into two groups to block in antenatal period.Results In 174cases of patients,sixty cases of parturient women with HBV-DNA capacity ＆lt; 5.0×102 copies/mL,intrauterine infection positive rate was 6.67%（4/60）;45cases of parturient women with HBV-DNA capacity in 5.0×102-1.0×106copies/mL,intrauterine infection positive rate was 13.33%（6/45）;69cases of parturient women with HBV-DNA capacity＆gt;1.0×106 copies/mL,intrauterine infection positive rate was 78.26%（54/69）,parturient with higher infection in HBV-DNA positive puerpera than HBV-DNA negative,it was significantly different among groups（χ2=35.72,P＆lt;0.01）.There was a significant difference between parturient intrauterine infection in HBV-DNA capacity in 5.0×102-1.0×106copies/mL and HBV-DNA capacity＆gt; 1.0×106copies/mL（χ2= 63.95,P＆lt;0.01）,indicating that the risk of maternal infection greatly increased along with the HBV-DNA capacity increased;in 114cases of HBV-DNA positive puerpera,positive rate of blocking group was 8.22%（6/73）,positive rate of control group was 31.73%（13/41）,positive rate of intrauterine infection in blocking group lower than those of control group,the difference was statistically significant（χ2=10.43,P＆lt;0.01）.Conclusion Hepatitis B HBV-DNA load are positively correlated with vertical transmission of mother and infant,through prenatal blocking can reduce vertical transmission between mother and infant.