乙型肝炎病毒携带产妇预防干预措施与母乳喂养的安全性研究

目的:调查乙型肝炎病毒(HBV)携带产妇的母乳喂养和人工喂养后婴儿血清HBV标志物(HBVM)的阳性率,为指导母乳喂养提供证据.方法:用ELISA法检测孕妇和婴儿血清中的HBVM,用荧光定量聚合酶链反应(PCR)法检测HBV携带产妇血清和初乳中HBV-DNA含量,并分析婴儿血清HBVM与母乳喂养和人工喂养的关系.结果:67例HBsAg抗原阳性(大、小三阳),产妇中,HBV血清‘大三阳'的产妇血液、初乳中HBV-DNA阳性率较高.母亲血清HBVM为‘大三阳'者分别占人工喂养组和母乳喂养组的41%和13%,两组间有显著性差异(P＜0.05);婴儿在12～18个月时作血清HBVM检测,人工喂养组和母乳喂养组婴儿血清抗-HBs阳性率分别为84%和87%,两组无显著性差异(P＞0.05).结论:只要对HBV携带产妇在孕期进行预防干预及对所产婴儿进行被动和主动免疫防范措施,HBV携带产妇的母乳喂养是相对安全的.

An investigation of reliability on breast-feeding to infants of hepatitis B virus markers positive mothers by active and passive immunization

Objective:To provide evidence instruction for breast-feeding,the investigation of positive rates with serum hepatitis B virus markers(HBVM) in infants of breast-feeding to HBVM positive mothers.Methods:The serum HBVM of pregnant women and their infants were determined by ELISA and HBV-DNA in positive serum and colostrum were determined by fluorescence quantitative PCR.The relation between HBVM in the infant serum and the feeding way was analysed.Results:In 67 parturients with serum HBVM antigen positive,the positive rates of HBV-DNA were 84%,26% and 27%,0% in serum and colostrum with HBeAg positive and HBeAg negative mothers;and there was a positive relationship between the serum and colostrum.The positive rates of HBeAg of mothers were 41% and 13% in the artificial feeding group and breast feeding group,there was significant difference between them( P <0.01).12-18 months after birth,the infants positive rates of serum anti-HBs were 84% and 87% in the artificial feeding group and breast feeding group( P >0.05).Conclusion:The breast-feeding were safe to HBVM positive mothers by active and passive immunization with pregnant women and their infants.