乙肝产妇乳汁 HBV-M和HBV-DNA检测及临床意义

目的 探讨乙肝产妇乳汁中HBV—M和HBV—DNA的关系，从而有助于正确指导乙肝产妇产后母乳喂养。方法采用电化学发光法定性检测乳汁HBV—M的含量，同时采用荧光定量PCR法检测乳汁HBV—DNA。结果 根据HBV的复制情况和传染性再指导乙肝产妇是否采用母乳喂养方式。在乳汁HBV—M阳性的807例中，HBV—DNA阳性177例．占21．9％；HBV—DNA阳性构成主要为HBsAg( )抗HBe( )模式(即大三阳组)，占66.1％，高于其他模式；807例乳汁中检得大三阳157例，其中HBV—DNA阳性117例，占74．5％，高于其他模式。结论 不同模式HBV—M阳性的乳汁中均存在HBV—DNA阳性，乳汁。HBV—DNA阳性者无论处于何种感染模式均建议采用人工喂养较为安全，临床应同时检测HBV—M和HBV—DNA以指导喂养方式。

Clinical significance and determinations of hepatitis B virus marker and HBV-DNA in breast milk of parturients with hepatitis B

Objective To investigate the relationship between HBV-Mand HBV-DNA in breast milk in order to determine whether the baby is fed by breast milk.Methods To detect HBV-M and HBV-DNA in breast milk by electrochemiluminescence immunoassay(ECLI)and fluorescence quantitative polymerase chain reaction(FQ-PCR),respectively.Results HBV-DNA positive rate was21.9%in807cases of HBV-Mpositive.The proportion of HBsAg,HBeAg and Anti-HBc positive group was66.1%among HBV-DNA positive mothers.The positive rate of HBV-DNA in HBsAg,HBeAg and Anti-HBc positive group was74.5%.Conclusions With the clinical implication of HBV-M and HBV-DNA,the parturients with the HBV-DNA positive were not suitable for breast feeding.Therefore,the two methods should be simula-taneously used in the detection of HBV infection to conduct breast feeding.