HBV-DNA的含量与宫内感染的关联性

目的：探讨孕妇血清中HBV—DNA含量与胎儿宫内感染及造成宫内感染的相关因素．方法：用ELISA方法筛选HBsAg阳性孕妇228例，并用定量PCR技术检测HBsAg阳性孕妇血清以及脐血中HBV—DNA．新生儿根据有无HBV感染分为胎儿感染组及非感染组（对照组），调查宫内感染的相关因素，结果：HBsAg，HBeAg、抗HBc阳性孕妇的新生儿脐血HBV—DNA捡出率21％（14／68）；HBsAg．抗HBe，抗HBc阳性者为1．7％（2／117）；HBsAg和HBeAg双阳性者为20％（3／15）；HBsAg和抗HBc阳性者为11％（2／19）；HBsAg单一抗原阳性者脐血中未捡出HBV—DNA．胎儿总感染率为9，2％（21／228）．胎儿宫内感染率随孕妇血清中HBV—DNA含量增加而升高，宫内感染的危险性越大．胎儿感染组与非感染组在多种临床相关因素中先兆早产孕妇胎儿感染者多于非感染组（P〈0．05）．结论：孕妇不同的感染状态影响宫内HBV感染率，HBeAg与HBV—DNA高滴度是胎儿宫内感染的高危因素．孕妇出现先兆早产使胎儿的感染率增加．

Relationship between serum hepatitis B virus DNA load and intrauterine infection in pregnant women

AIM: To study the relationship between serum hepatitis B virus (HBV) DNA load in pregnant women and intrauterine infection as well as other relative factors. METHODS: Two hundred and twenty-eight cases of HBsAg positive pregnant women were screened out by ELISA. HBV-DNA content was detected with fluorescence quantitative polymerase chain reaction (PCR)in HBsAg positive pregnant women and their fetal cord blood. According to the results of HBV-DNA, the newborns were divided into infected group and non-infected group(control group). Relative factors were investigated in infected group and control group with intrauterine infection. RESULTS: Cord blood positivity rate of HBV-DNA was 21%(14/68)in HBsAg, HBeAg and anti-HBc positive pregnant women, 1.7%(2/117)in HBsAg, anti-HBe and anti-HBc positive pregnant women, 20%(3/15)in HBsAg and HBeAg positive pregnant women, and 11%(2/19)in HBsAg and anti-HBc positive pregnant women. HBV-DNA was not detected in only HBsAg positive pregnant women. The total infection rate in fetus was 9.2%. Intrauterine infection rate increased significantly when HBV-DNA level increased in the blood of pregnant women and the risk for fetal intrauterine infection also increased. Threatened premature labor in fetal infection group was higher than that in control group(P<0.05). CONCLUSION: Intrauterine infection rate is associated with the HBV infection status of the pregnant women. HBeAg positivity and high level of maternal HBV-DNA are the high risk factors of fetal intrauterine infection. Threatened premature labor in pregnant women may lead to higher infection rate in fetus.