乙肝病毒表面抗原阳性孕妇分娩新生儿乙肝病毒标志的临床意义

目的探讨乙肝病毒表面抗原(HBsAg)阳性孕妇分娩新生儿乙肝病毒标志的临床意义。方法对1999-07—2002-06北京地坛医院儿科996例新生儿生后第3天检测静脉血乙肝病毒标志，追踪观察199例成长到3个月至4岁，将乙肝病毒标志HBsAg和HBeAg进行分析。结果新生儿生后第3天HBsAg和HBeAg阳性率分别为27.2%(271/996)、48.1%(479/996)，有495例检测抗-HBc，阳性率高达99.2%(491/495)。在生后3个月至4岁间复测乙肝病毒标志199例，有17例感染乙肝病毒，占8.5%(17/199)。分别比较生后第3天血清HBsAg、HBeAg滴度，感染乙肝病毒新生儿的HBsAg滴度高于未感染新生儿(P<0.01)，而HBeAg滴度水平差异不明显(P>0.05)。将感染、未感染乙肝病毒儿童复查结果与生后第3天血清HBsAg、HBeAg滴度分别进行比较，17例感染乙肝病毒儿童血清HBsAg和HBeAg滴度明显升高(P<0.001，P<0.05)，而182例未感染儿童明显减低(P<0.001)。结论HBsAg阳性孕妇分娩新生儿血清HBsAg、HBeAg和抗-HBc阳性不能作为诊断感染乙肝病毒的依据，新生儿血清HBsAg滴度较高并在生后3个月逐渐升高，可以作为儿童感染乙肝病毒的诊断依据。

Clinical analysis of HBV markers in infants of HBsAg-positive mothers.

AbstractObjectiveTo explore clinical features of the markers in newborns of mothers with HBsAg-positive.MethodsHBV markers in serum were determined in 996 infants of 3-day-old，199 of them followed up for periods from 3 months to 4 years.ResultsHBsAg and HBeAg in serum in newborns of the third day of life were 27.2%(271/996) and 48.1%(479/996),respectively.The number of anti-HBc positive was 99.2%( 491/495).Seventeen infants were confirmed to be HBV infection (8.5%，17/199).There was significant difference in the expression of HBsAg in serum in the infected infants with higher loud and HBeAg showed no significant difference as compared to non-infected infants on the third day after birth.In comparison between sera collected from the third day of age and following-up in the infected HBV children,HBsAg and HBeAg of the latter were markedly higher respectively,P<0.001，P<0.05.In non-infected HBV children(182cases),levels of both HBsAg and HBeAg decreased obviously，P< 0.001.ConclusionThe positive HBV markers in serum are predominant in newborn infants of mothers with HBsAg-positive,which can not be considered the markers of HBV infection.High levels of HBsAg and HBeAg in serum can be defined as a high predictor of children with HBV infection after 3 months of age.