HBV Pre-S1蛋白与胎儿宫内感染

目的:探讨HBV前S1蛋白与胎儿感染的相关性,为筛查HBsAg阳性孕产妇中可能感染胎儿的高危人群提供参考依据。方法:采用酶联免疫吸附试验(ELISA)双抗体夹心方法、分级定量PCR检测、酶联免疫吸附试验,检测256例HBV携带孕妇及其分娩的256例新生儿静脉血前S1蛋白、HBV DNA及HBV标志物。结果:①256例新生儿中发生HBV感染81例,感染率为31.6%。②前S1蛋白阳性孕产妇所分娩的85例新生儿中,感染率为88.2%(75/85),显著高于前S1蛋白阴性者的3.5%(6/171)(P<0.01)。③在感染的81例新生儿中,有79例其母前S1蛋白阳性(97.5%)(79/81),81例其母HBVDNA阳性,两者差异无统计学意义(P>0.01)。结论:①孕妇单纯HBsAg阳性,其婴儿感染率相对较低,如合并有前S1蛋白阳性或HBV DNA阳性,则胎盘传播率显著上升;②前S1蛋白检测可以代替血HBV DNA检测作为判断胎儿宫内感染的重要依据,可作为筛查HBsAg阳性孕产妇中易发生垂直传播人群的方法。

HBV Pre-S1 protein and fetal intrauterine infection

Objective:To explore the correlation between HBV Pre-S1 protein and fetal infection,provide reference for screening the high risk population who may infect fetuses among the HBsAg positive pregnant women.Methods:ELISA double antibody sandwich method,grading quantitative PCR,and ELISA were used to detect HBV Pre-S1 protein,HBV DNA,and HBV markers in venous blood samples of 256 pregnant women carrying HBV and 256 neonates born by them.Results:Among 256 neonates,81 neonates were infected by HBV,the infection rate was 31.6%.Among 85 neonates born by pregnant women with positive HBV Pre-S1 protein,75 neonates were infected,the infection rate was 88.2%,which was statistically significantly higher than that in neonates born by pregnant women with negative HBV Pre-S1 protein(3.5%(6/171))(P<0.01).Among 81 infected neonates,the mothers of 71 neonates were found with positive HBV Pre-S1 protein(97.5%(79/81)),and the mothers of 81 neonates were found with positive HBV DNA,there was no statistically significant difference(P>0.01).Conclusion:The infection rate of HBV in neonates whose mothers are found with simple positive HBsAg is low,if the mothers are found with positive HBsAg combined with positive HBV Pre-S1 protein or positive HBV DNA,the transplacental transmission rate of HBV increases significantly;as an important criterion to predict fetal intrauterine infection,HBV Pre-S1 protein detection can replace HBV DNA detection,which can be used as a method to screen the population who are easy to occur vertical transmission among pregnant women with positive HBsAg.