孕妇HBV感染模式与宫内感染关系的临床研究

目的了解孕妇乙型肝炎病毒(HBV)感染状况、感染模式及其与新生儿宫内感染的关系。方法ELISA法检测孕妇及部分新生儿血清乙型肝炎血清标志物(HBVM),PCR法检测血清及外周血单核细胞(PBMC)内HBV-DNA。结果孕妇HBV感染率为8.63%(264/3060),HBsAg阳性率为8.19%(251/3060),孕妇HBV感染模式有12种,以“小三阳”模式较多见,占孕妇感染总数的35.98%(95/264)。“大三阳”、“小三阳”孕妇HBV-DNA检出率分别为97.73%(43/44)和26.31%(25/95),差异有显著性意义(P<0.05)。HBeAg(+)、血清HBV-DNA(+)及PBMC中HBV-DNA(+)孕妇宫内感染率分别为46.15%(6/13)、66.67%(8/12)、70.00%(7/10)。结论孕妇中存在一定数量和程度的HBV感染;感染模式以“小三阳”多见,“大三阳”孕妇体内HBV复制水平较高,易发生宫内感染。HBV宫内感染与孕妇HBeAg(+)及HBV-DNA(+)有关。

Relationship of the Modes of Hepatitis B Virus Marker in Pregnant Women with Intrauterine Infection

Objective: To explore the relationship of the modes of hepatitis B virus marker (HBVM) in pregnant women with intrauterine infection. Methods: HBVM and HBV-DNA in serum and peripheral blood mononuclear cells (PBMC) of pregnant women and some of their neonates were detected by the methods of ELISA and PCR, respectively. Results: The total of HBV infection and positive of HBsAg in pregnant women were 8.63%(264/3060) and 8.19%(251/3060). Twelve modes had been confirmed and it was more common in the mode of positive of HBsAg, anti-HBe, anti-HBc which was possessed of 35.98%(95/264). The positive rates of HBV-DNA in HBsAg( ), HBeAg ( ), anti-HBc ( ) mode and HBsAg( ), anti-HBe( ), anti-HBc ( ) mode were 97.73%(43/44) and 26.31%(25/95), which showed significantly different (P<0.05). The HBV intrauterine infection rates were 46.15%(6/13), 66.67%(8/12) and 70.00%(7/10) in pregnant women with positive of HBeAg, HBV-DNA in serum and HBV-DNA in PBMC. Conclusion: It shows that infection of HBV is presented in some pregnant women and the mode of HBsAg( ), anti-HBe( ), anti-HBc ( ) is more common. High duplication level of HBV is expressed in positive mode of HBsAg( ), HBeAg ( ), anti-HBc ( ) and easy to induce the intrauterine infection. The intrauterine infection of HBV can be associated with the level of HBeAg( ) and HBV-DNA( ) in pregnant women.