HBV母婴垂直传播相关影响因素研究

目的探讨妊娠合并HBV感染的孕妇母婴垂直传播的相关影响因素。方法收集100例乙肝病毒携带孕妇及其100例新生儿作为研究对象,采用双抗体夹心时间分辨免疫荧光法（IFMA法）检测孕妇HBs Ag和HBe Ag,实时荧光定量PCR法检测HBV DNA载量,并用流式细胞仪检测新生儿脐血中NK细胞CD69和IFN-γ,并对以上指标的相关性进行统计分析。结果母血中HBs Ag单阳性与HBs Ag/HBe Ag双阳性组间母婴垂直传播比率差异有统计学意义（P〈0.001）;孕妇外周血HBV DNA载量越高母婴垂直传播几率越高。妊娠合并乙型肝炎患者中HBV母婴垂直传播组、未发生HBV母婴垂直传播患者与正常对照组三组间脐血中T淋巴细胞中活化标志物CD69表达的细胞百分比分别为：（9.58±1.745）%、（15.6±2.117）%和（5.66±3.724）%,差异有统计学意义（P〈0.001）。HBV母婴垂直传播与IFN-γ无明显相关性（P〉0.05）。结论母血HBe Ag阳性与否、HBV DNA病毒载量高低直接决定着母婴HBV垂直传递的风险,同时T淋巴细胞中活化标志物CD69表达水平与母婴HBV垂直传播相关,该研究的结果为临床研究HBV母婴传播的机理及其预防措施,减少HBV携带者,提高新生儿出生质量有重要意义。

Study on the Influencing Factors Related to Mother-to-child Vertical Transmission of HBV

Objective To investigate the influencing factors related to mother-to-child vertical transmission of hepatitis B virus infection. Methods 100 cases of hepatitis B virus carrying pregnant women and their 100 newborns were selected as the research object. HBs Ag and HBe Ag of the pregnant women were detected by IFMA method, and HBV DNA load of them was detected by real-time PCR. NK cells CD69 and IFN-γ in the umbilical cord blood of the newborns were detected by flow cytometry. And the relativity between the above indexes was analyzed statistically. Results The difference in the ratio of mother-to-child vertical transmission of HBV between the pregnant women with positive HBs Ag and those with double positive HBs Ag /HBe Ag was statistically significant（P〈0.001）. The higher HBV DNA load in the maternal blood, the higher HBV mother-to-child vertical transmission ratio would be. T lymphocyte activation marker CD69 expression levels in the hepatitis group with mother-to-child vertical transmission of HBV, hepatitis group without mother-to-child vertical transmission of HBV, and the normal control group was（9.58 ±1.745）%,（15.6±2.117）%,（5.66±3.724）%, respectively, the difference was statistically significant（P〈0.001）. And mother-to-child vertical transmission of HBV had no significant relativity with IFN-γ（P〉0.05）. Conclusion Positive HBe Ag and HBV DNA load in the maternal blood are associated with the risk of mother-to-child vertical transmission of HBV. And T lymphocyte activation marker CD69 expression levels are related to mother-to-child vertical transmission of HBV. The results of this study are about the mechanism and preventive measures of mother-to-child vertical transmission of HBV clinically, which are of great significance in reducing the HBV carriers and improving the quality of neonates.