新生儿乙型肝炎病毒宫内感染及其影响因素的随访研究

目的了解发生乙型肝炎病毒宫内感染的新生儿的转归情况,并探讨影响新生儿乙型肝炎病毒宫内感染的相关因素。方法对HBsAg阳性母亲及新生儿进行随访。应用酶联免疫吸附试验双抗夹心法检测HBsAg阳性孕妇及其新生儿血清乙型肝炎病毒标志物,采用聚合酶链反应技术检测血清乙型肝炎病毒DNA。分析比较新生儿宫内感染组和非宫内感染组的差异,并对母亲HBeAg阳性与宫内感染新生儿乙型肝炎病毒慢性化的关系进行分析。结果随访到214对HB-sAg阳性母亲及其新生儿,有10例新生儿发生宫内感染,其中2例发生乙型肝炎病毒慢性感染。母亲既往HBsAg和HBeAg双阳性、母亲既往乙型肝炎病毒DNA阳性在新生儿宫内感染组和非宫内感染组中的分布差异有显著性(χ2值分别为6.68和14.80,P<0.05)。母亲既往HBeAg阳性在新生儿乙型肝炎病毒慢性感染组和非乙型肝炎病毒慢性感染组中的分布差异有显著性。结论母亲既往HBsAg和HBeAg双阳性、既往乙型肝炎病毒DNA阳性可能导致新生儿宫内感染危险增加,母亲既往HBeAg阳性可能导致新生儿乙型肝炎病毒慢性感染。

A follow-up study on influence factors of newborn infants with hepatitis B virus intrauterine infection

Objective To observe the development of infants with Hepatitis B virus intrauterine infection and to study correlation factors of infants with Hepatitis B virus intrauterine infection.Methods Correlation factors between infection group and non-infection group were analysed and compared total 214 mother with HBsAg positive and their infants were follow-up investigated respectively.HBV marker of all subjects were detected by enzyme-linked immunosorbent assay,and HBV DNA were detected by the technique of polymerase chain reaction.The relation between newborn infants chronic HBV infection and maternal serum HBeAg was analysed.Results In the total of 214 follow-up subjects,there were 10 newborn infants intrauterine infection.Among those subjects,two newborn infants were transformed to chronic HBV infection.There was significant difference of distribution of maternal serum HBeAg positive persistently between chronic HBV infection and non-chronic HBV infection.Conclusions Maternal serum HBsAg,HBeAg double positive and maternal HBV DNA positive increased the risk of HBV intrauterine infection.Maternal serum HBeAg persistently positive resulted in newborn infants chronic HBV infection.