孕妇乙型肝炎病毒感染与宫内感染的研究

目的:研究孕妇乙型肝炎病毒感染程度和宫内感染的关系,评价E抗原定量检测在研究宫内感染中的应用价值。方法:应用ECL2010电化学发光分析仪对69例携带HBV的孕妇静脉血及其新生儿脐血进行E抗原定量检测,同时用ELISA方法测定乙型肝炎标志物及用PCR技术检测HBVDNA,所有新生儿随访一年。结果:在69例被检者中,HBsAg、HBeAg双阳性孕妇32例,E抗原均>1U/ml,HBVDNA均为105拷贝/ml或以上,宫内感染率62·50%。而HBsAg阳性和HBeAb或HBcAb阳性的孕妇,E抗原均<1U/ml,HBVDNA有2例<103拷贝/ml,21例为104拷贝/ml,14例为105拷贝/ml或以上,宫内感染率为13·51%(χ2=85·93,P<0·001)。孕妇E抗原>1U/ml,HBsAg、HBeAg双阳性和或HBVDNA高含量是宫内感染HBV的高危因素。结论:测定E抗原含量用以诊断及评价宫内感染具有灵敏、可靠、快捷的优点。

Study on HBV infection and intrauterine infection in pregnant women

Objective:To study the relationship between degree of HBV infection and intrauterine infection in pregnant women and determine the value of quantitative detection of HBeAg in diagnosis of intrauterine infection.Methods:HBeAg was quantitatively detected in blood samples from 69 pregnant women with HBV infection and their neonate's umbilical cord by ECL2010 electrochemical luminescent analyzer. Meanwhile, HBsAg, HBeAg, HbeAb and HBcAb were detected with ELISA and HBV DNA determined with PCR. All infants were followed up for 1 year.Results:Of the 69 women, 32 exhibited double positivity of HBsAg and HbeAg. In these 32 women, the level of HBeAg >1 U/ml, HBVDNA 105 copy/ml or >105 copy/ml and the rate of intrauterine infection was 62.5%.In other 37 HbeAg-negative women, the level of HBeAg<1 U/ml and the rate of intrauterine infection was 13.5%.The high-risk factors for intrauterine factors were the level of HBeAg>1 U/ml, double positivity of HBsAg and HBeAg and high concentration of HBV DNA.Conclusion:Quantitative detection of HBeAg is a highly sensitive, rapid, simple and reliable method for diagnosis of intrauterine infection.