探讨乙型肝炎病毒携带产妇HBV-DNA水平对新生儿的影响

目的探讨乙型肝炎病毒携带产妇血清HBV－DNA水平对乳汁和新生儿HBVDNA水平的影响，以此指导孕期处理和喂养方式。方法选择2012年1～12月的乙型肝炎病毒携带产妇120例，检测产妇血清、乳汁和新生儿血清中的HBV-DNA水平，对结果进行综合分析。结果64例产妇血清HBV－DNA〈500copies／mL，其乳汁HBV－DNA检出阳性为1例，新生儿血清HBVDNA检出阳性1例；29例产妇血清HBV－DNA水平为500copies／mL至1．0×106copies／mL，其中4例乳汁HBVDNA检出阳性，新生儿血清HBV-DNA检测均为阴性；27例产妇血清HBV-DNA水平大于或等于1．0×106copies／mL，其中25例乳汁HBV-DNA阳性，1例新生儿血清HBV-DNA检测阳性。结论产妇血清HBV-DNA水平大于或等于1．0×106copies／mL时，产妇乳汁中的HBV-DNA阳性检出率将大幅度增加，应该禁止母乳喂养；产妇血清中HBV-DNA水平对于宫内传播无明显影响。

Effect on the newborn of maternal HBV-DNA levels in HBV carriers

Objective To explore the effect on the newborn of maternal HBV DNA levels in HBV carriers. So as to guide the treatment during pregnancy and breast feeding. Methods 120 cases of puerperas carried HBV were chosen from January 2012 to December 2012. The HBV-DNA levels in maternal serum, breast milk and neonatus serum were detected. And the results were an alyzed comprehensively. Results The maternal serum HBV-DNA quantity of 64 cases were lower than 500 copies/mL. There was one case of breast milk HBV-DNA positive and one case of neonatal serum HBV-DNA positive. The maternal serum HBV DNA quantity of 29 cases ranged from 500 copies/mL to 〈 1.0 ×106 eopies/mL,4 cases showed HBV-DNA positive in breast milk, and no one showed HBV DNA positive in neonatal serum. The maternal serum HBV-DNA quantity of 27 cases were ≥1.0 × 106 cop ies/mL, 25 eases showed HBV-DNA positive in breast milk,and one case showed HBV-DNA positive in neonatal serum. Conclusion When maternal serum HBV-DNA quantity was 1.0× 106 eopies/mL, the HBV-DNA positive rate in breast milk increases sharp ly,and breastfeeding should be prohibited. Maternal serum HBV DNA concentration has little effect on intrauterine transmission.