HBV垂直传播的细胞分子机制研究

目的:探讨HBV垂直传播状况、细胞分子机制及其对胎儿的影响.方法:将46例HBV感染孕妇按HBeAg(+)和HBeAg(-)进行分组,以PCR法对46例HBV感染孕妇产前血清及外周血单个核细胞(PBMC)中HBV-DNA进行检测,并对新生儿脐血血清及脐血单个核细胞(CBMC)中HBV-DNA进行检测,同时选取10例健康孕妇为正常对照.结果:HBV感染孕妇血清及PBMC中HBV-DNA的阳性率分别为69.57%(32/46)和41.30%(19/46),分娩时新生儿脐血血清及CBMC中HBV-DNA的阳性率分别为56.52%(26/46)和21.74%(10/46).其中HBeAg(+)组孕妇血清及PBMC中HBV-DNA的阳性率分别为100.00%(25/25)和60.00%(15/25);分娩时新生儿脐血血清及CBMC中HBV-DNA的阳性率分别为88.00%(22/25)和32.00%(8/25).HBeAg(-)组孕妇血清及PBMC中HBV-DNA的阳性率分别33.33%(7/21)和19.05%(4/21),分娩时新生儿脐血血清及CBMC中HBV-DNA的阳性率分别为19.05%(4/21)和9.52%(2/21).两者相比差异有显著性(P＜0.01和P＜0.05).健康孕妇血清、PBMC及其所分娩新生儿脐血血清、CBMC中均未检出HBV-DNA.结论:HBV确可经胎盘垂直传播,其传播途径可通过直接传播,亦可通过PBMC介导,PBMC介导的HBV垂直传播较隐匿,HBeAg(+)孕妇发生HBV垂直传播的危险性高.

Study on the Cellular Molecular Mechanism of Intrauterine Transmission of Hepatitis B Virus

Objective: To study intrauterine transmission of HBV and its cellular molecular mechanism and influence on the fetus. Methods: A total of 46 cases of pregnant women who suffered from HBV were divided into HBeAg (+) and HBeAg (-) groups. HBV-DNA in serum and peripheral blood mononuclear cells (PBMC) of 46 cases of pregnant uomen before delivery was detected by polymerase chain reaction (PCR). After placenta being delivery, HBV-DNA in serum and cord blood mononuclear cells (CBMC) was also detected by PCR. Results: The total of positive rates of HBV-DNA in serum and PBMC of pregnant women with hepatitis B were 69.57% (32/46) and 41.30% (19/46). The positive rates of HBV-DNA in serum of cord blood and CBMC were 56.52%(26/46) and 21.74% (10/46) respectively. Among them, the positive rates of HBVDNA in serum and PBMC of pregnant women with HBeAg (+) were 100. 00% (25/25) and 60. 00% (15/25) respectively. The positive rates of H BV-D N A in serum of cord blood and C B M C were 88. 00% (22/25) and 32. 00% (8/25) respectively. The positive rates of HBV-DNA in serumand PBMC of pregnant wormen with HBeAg (-) were 33. 33% (7/21) and 19. 05% (4/21) respectively. The positive rates of HBV-DNA in serum of cord blood and CBMC were 19.05%(4/21) and 9.52% (2/21) respectively. The positive rates of HBV-DNA in serum of cord blood and CBMC of newborns were higher in the group of pregnant women with HBeAg (+) than those in the group of pregnant women with HBeAg (-) (P＜0. 01 and P＜0. 05). There was no HBV-DNA in serum, PBMC and CBMC of normal pregnant women and normal neonates. Conclusion: The intrauterine transmission of HBV can be existent and its transmission way not only can be induced by serum but also can be induced by PBMC. The way of intrauterine transmission of HBV induced by PBMC was concealed. The dangerous possibility of intrauterine transmission is higher in the pregnant women with HBeAg (+) than that in thegroup of pregnant women with HBeAg (-).