孕产妇及其新生儿的HBV检测结果相关性分析

目的 通过对HBsAg阳性孕产妇及其新生儿的HBV检测结果分析,探讨HBV宫内感染的高危因素及其预防措施。方法 从陕西省人民医院产前检查中筛选254例HBsAg阳性孕产妇及其新生儿作为研究对象,检测两者HBV标志物,并同时用荧光定量PCR检测孕产妇血清HBV-DNA。结果 254例HBsAg阳性孕产妇,其新生儿脐血HBsAg和HBeAg阳性率分别为5.12%和13.78%; HBeAg阳性组孕产妇的新生儿脐血HBV感染阳性率53.33%,远高于HBeAg阴性组的3.61%,差异有统计学意义(P<0.001); 新生儿脐血HBsAg和HBeAg阳性率随孕产妇HBV-DNA含量的增加而升高,差异有统计学意义(K-W秩和检验,P<0.001); HBeAg阳性孕产妇的HBV-DNA检测阳性率100.00%,远高于HBeAg阴性孕产妇的阳性率19.59%,差异有统计学意义(Fisher确切概率法,P<0.001)。结论 孕产妇HBeAg和HBV-DNA阳性是新生儿HBV宫内感染的高危因素; 对于没有实时定量检测条件的基层医院和妇幼保健院,HBeAg筛查就尤为重要; 对育龄妇女孕前进行HBV的干预和治疗,使HBV-DNA和HBeAg转阴后妊娠,是降低HBV宫内感染的有力措施。

Correlation Analysis of Maternal and Neonatal HBV Test Results

Objective To investigate the risk factors of intrauterine hepatitis B virus(HBV)infection and its preventive measures.Methods 254 cases of pregnant women with positive HBsAg and their neonatuses from Shaanxi People's Hospital were selected as the research object.The serum of pregnant women were tested HBV markers and HBV-DNA,their neonatal umbilical cord blood were only detected HBV markers.ResultsIn 254 samples,the positive rates of HBsAg and HBeAg within their neonatal umbilical cord blood were 5.12% and 13.78% respectively; the positive rate of HBV infection in neonatal umbilical cord blood among maternal HBeAg-positive group was 53.33%,far higher than 3.61% in HBeAg-negative group(χ²=99.44,P<0.001); the positive rates of HBsAg and HBeAg in neonatal umbilical cord blood were elevated along with the increase of maternal HBV-DNA copy(Hc=13.50,66.70; P<0.001).The positive rate of HBV-DNA inpregnant women with HBeAg-positive group was 100%,far more than 19.59% in HBeAg-negative group(P<0.001).Conclusion Both maternal positive HBeAg and HBV-DNA are risk factors for neonatal intrauterine HBV infection.Prenatal HBeAg screening is predominant,especially in some hospitals without real-time quantitative assay.An effective measure to reduce intrauterine HBV infection is to be pregnant when HBV DNA and HBeAg are turned into negative after HBV intervention and treatment for women in reproductive age.