HBV-经胎盘感染胎儿的机理研究

目的 研究HBV经胎盘感染胎儿机理。方法 应用PCR技术检测59例HBsAg( )孕妇血清、胎盘及新生儿脐血清中HBV DNA。采用免疫组化ABC染色法检测胎盘中HBsAg及HBcAg。结果 新生儿宫内感染率为45．8％(27／59)；胎盘HBV DNA( )者宫内感染率达78．8％(26／33)，均显著高于其HBV DNA(-)者。免疫组化染色HBsAg阳性率为81．4％(48／59)，HBcAg阳性率达61．6％(36／59)。HBsAg及HBcAg在胎盘中分布由蜕膜细胞、滋养层细胞、绒毛间质细胞，绒毛毛细血管内皮细胞依次递减，羊膜上皮细胞中可检出HBsAg及HBcAg。结论 HBV经胎盘感染胎儿机理可能是HBV经母血和／或细胞直接蔓延感染胎儿，或HBV经母血和／或细胞蔓延至羊膜，经羊水感染胎儿。

A STUDY OF THE MECHANISM OF INTRAUTERINE TRANSMISSION OF HEPPATITIS B VIRUS

Objective To study the mechanism of intrauterine transmission of Hepatitis B virus(HBV).Methods HBV DNA in serum, amniotic fluid, secretion of vagina and placenta of 59 mothers with HBsAg and HBcAg in placenta were detected by PCR.HBsAg and HBcAg in placenta were detected by immunohistochemical chiomoscopy. Results Intrauterine infection rate of placenta, amniotici flaid and secretion of vagina HBV DNA( )(78.8%, 78.6%, 80.6%)were respeclively significantly higher than that of HBV DNA(-). The positive rate of placenta HBsAg and HBcAg was 81.4%, 61.6%. HBsAg and HBcAg in placenta decreased gradually from maternal deciduas cell, chorionis epithelion, and chorionic interstitial cell to capillary end othelium of chorion. HBsAg and HBcAg was detected amniotic epithelium in part of placenta. It in the part of placenta increased gradually from deciduas cell to capillary endothelium. HBsAg and HBcAg were detected in amniotic epithelium. HBV DNA was detected in amniotic fluid and secretion of vagina. Conclusion Intrauterine transmission to infant was via mother blood and/or cell spreading directly and virginal separately ascending infection.