死胎大脑组织中HBsAg检测的临床和病理研究

 目的 观察乙型肝炎病毒是否通过产妇传播并在胎儿大脑组织表达。方法 采集40例乙型肝炎产妇产下的死胎，常规尸检，取大脑组织，SP法检测HBsAg；回访婴母产前静脉血HBV的检测结果。结果 HBsAg阳性颗粒在死胎的大脑胶质细胞浆、血管中点、灶状分布，大脑胶质细胞细胞核不着色。HBsAg阳性、(HBsAg、HBeAb、HBcAb皆阳性)、(HBsAg、HBeAg、HBcAb皆阳性)的婴母分娩的死胎大脑组织中HBsAg阳性几率分别为8／33、0／2、0／5例，三者比较，差异无统计学意义(P＞0.05)。结论 乙型肝炎病毒可以通过母婴垂直传播在胎儿大脑组织中表达；其表达与孕妇静脉中乙型肝炎病毒标志物(HBVM)无关。

Detection of HBsAg in cerebral tissues of stillborn fetuses infected with hepatitis virus B

Objective To observe if there is expression of HBsAg in the cerebral tissues of dead fetuses infected by HBV by maternal-fetal transmission. Methods Cerebral tissues of 40 dead fetuses borne by mothers infected with hepatitis virus B were examined for HBsAg by immunocytochemistry(SP). HBVM in the mothers' vein before delvery was investigated. Results HBsAg in the cerebral tissues, which were single or in clusters distributed on the surface of the cerebral vessels and in the plasma of the astrocytes, were detected. No HbsAg were found in the nuclei of astrocytes. The probabilities of delivering stillborn fetuses with HBsAg - positive cerebral tissues in HBsAg - positive, (HBsAg, HBeAb.and HBcAb) - positive and (HBsAg,HBeAg,HBcAb) - positive mothers were 24.24%(8/33 caces) ,0(0/2) and 0(0/5) .respectivelyi; the differences between them were not statistically significant P > 0.05) .Conclusion There is expression of HBsAg in the cerebral tissuen of stillborn fetuses infected with HBV by maternal-fetal transmission, which is not related to the marker of HBV in the serum of mothers.