乙肝表面抗原阳性产妇母乳喂养的安全性研究

目的:探讨影响HBsAg阳性产妇母乳喂养的因素,为指导母乳喂养提供相关实验室和临床依据。方法:用ELISA法检测孕妇和婴儿血清中的乙型肝炎病毒血清标志物(HBVM),用荧光定量聚合酶链反应法(FQ-PCR)检测HBV携带产妇血清和初乳中HBV-DNA含量,并分析婴儿血清HBVM与母乳喂养和人工喂养之间的关系。结果:67例HBVAg阳性(大三阳、小三阳)产妇中,HBV血清“大三阳”的产妇血液、初乳中HBV-DNA检出率较高,分别为84%和26%。母亲血清HBVM为“大三阳”者分别占人工喂养组和母乳喂养组的41%和13%,两组间差异具有显著性(P<0.05);婴儿在12个月~18个月时作血清HBVM检测,人工喂养组和母乳喂养组婴儿血清抗-HBs阳性率分别为84%和87%,两组差异无显著性(P>0.05)。结论:HBV携带产妇只要在孕期进行预防干预及对所产婴儿进行被动和主动免疫防范措施,当产妇乳汁中HBV-DNA阴性时进行母乳喂养是相对安全的。

Investigation of Reliability on Breast - feeding to Infants of Hepatitis B Virus Markers Positive Mothers

Objective To study the effect on the infants who were breast-fed by the HbsAg positive mothers, and provide acorrelation evidence in laboratory for instruction breast-feeding. Methods The serum HBVM of pregnant women and their infants(12～18th month) were determined by ELISA and HBV-DNA in positive serum and colostrum were determined by real-time fluorescence quantitative PCR. The relation between HBVM in the infant serum and the feeding way was analyzed. Results In 67 cases parturient of serum HBVM antigen positive , the positive rate of HBV-DNA was 84% , 26% in serum and colostrum with HBeAg positive and HBeAg negative mothers ; and there was a positive relationship between the serum and colostrum. The positive rate of HBeAg of serum mothers were 41 % and 13 % in the artificial feeding group and breast feeding group , there was significant difference between them(P<0.01) . After 12～18 months , the infants positive rate of serum anti-HBs was 84 % and 87 % in the artificial feeding group and breast feeding group (P>0.05).Conclusion As determinations of HBV-DNA were negative in colostrum , the breast-feeding was safe to HBVM antigen positive mothers by active and passive immunization with pregnant women and their infants.