乙肝孕妇血清病毒标志物模式与宫内感染的关系

目的:检测乙肝感染孕妇的血清乙肝病毒标志物及所产新生儿脐血清HBV-DNA,探讨孕妇乙肝感染状况与新生儿宫内感染的关系,寻找有效阻断乙肝宫内感染的措施。方法:采用ELISA法检测302例乙肝感染孕妇血清乙肝病毒标志物,用Realtime-PCR法检测新生儿脐血清HBV-DNA。结果:"大三阳"和"小三阳"孕妇分别占64.90%和21.19%,"大三阳"组孕妇的新生儿脐血清HBV-DNA阳性率为46.88%,明显高于"小三阳"组的1.02%。孕妇血清HBeAg阳性组的新生儿脐血清HBV-DNA阳性率为46.27%,远高于阴性组的1.28%。结论:孕妇乙肝感染状况与新生儿宫内感染率密切相关,孕妇血清HBeAg可作为宫内感染发生的预测指标;HBeAg阳性妇女待HBeAg转阴后再妊娠,可大大减少宫内感染的发生。

Relationship between serum hepatitis B virus markers mode and intrauterine infection in pregnant women with hepatitis B

Objective:To detect serum hepatitis B virus(HBV) markers of hepatitis B-infected pregnant women and umbilical cord serum HBV-DNA of their neonates,explore the relationship between hepatitis B infection status of pregnant women and intrauterine infection of their neonates,and find effective measures to block intrauterine infection of hepatitis B. Methods:ELISA was used to detect serum HBV markers of 302 hepatitis B-infected pregnant women,and RT-PCR was used to detect umbilical cord HBV-DNA of their neonates. Results:The pregnant women with "HBsAg(+),HBeAg(+),and HBcAb(+)" and "HBsAg(+),HBeAb(+),and HBcAb(+)" accounted for 64.90% and 21.19%,respectively.The positive rate of umbilical cord HBV-DNA of neonates born by pregnant women with "HBsAg(+),HBeAg(+),and HBcAb(+)" was 46.88%,which was significantly higher than that of neonates born by pregnant women with "HBsAg(+),HBeAb(+),and HBcAb(+)"(1.02%).The positive rate of umbilical cord HBV-DNA of neonates born by pregnant women with positive serum HBeAg was 46.27%,which was significantly higher than that of neonates born by pregnant women with negative serum HBeAg(1.28%). Conclusion:HBV infection status of pregnant women is closely correlated with morbidity of intrauterine infection of their neonates,serum HBeAg of pregnant women can be used as a marker to predict the occurrence of intrauterine infection of HBV;the pregnant women with positive serum HBeAg can get pregnancy after negative conversion of HBeAg,which may reduce the morbidity of intrauterine infection significantly.