CAJ | 학술논문

目的探讨胎儿宫内乙型肝炎病毒(HBV DNA)感染的实验诊断方法及其临床意义.方法应用酶联免疫吸附试验(ELISA)和荧光定量聚合酶链反应(FQ-PCR)对156例乙肝表面抗原(HBsAg)阳性孕妇的母血和产后婴儿脐血及婴儿外周血的乙型肝炎血清学标志物(HBV-M)和HBV DNA进行检测.结果156例HDsag阳性孕妇所生婴儿脐血和婴儿外周血HBsAg的检出率为8 3%(13/156)、6.4(10/156),HBeAg检出率分别为7.1%(11/156)、5.1%(8/156),母血、脐血、婴儿外周血HBV DNA阳性检出率分别为36.5%(57/156)、28.2%(44/156)、23.7%(37/156);57例HBV DNA阳性孕妇血病毒含量(拷贝数/ml的对数值)为7.34±2.28,37例阳性婴儿外周血HBV DNA含量为6.08±0.96;与婴儿外周血检测结果相比较,脐血中HBsag、HBeAg的阳性率不仅存在23.1%和37.5%的假阳性,HBV DNA也存在16.7%(7/42)的假阳性;在HBeAg或HBV DNA阳性孕妇中,婴儿外周血HBV DNA的检出率分别为73.8%(31/42)、64.9%(37/57),显著高于HBeAg或HBV DNA阴性者5.3%(6/114),(P＜0.01):婴儿外周血中HBV DNA阳性率随孕妇HBVDNA含量增加而显著增加(P＜0.005),其HBV DNA的含量与母血呈正相关,(r=0.39).结论婴儿脐血HBV检测是诊断胎儿宫内HBV感染的筛选指标,而婴儿外周血的检测才具有确诊意义;HBV DNA定量检测是胎儿宫内HBV感染和感染程度最为直接、敏感的诊断方法;孕妇HBeAg、HBV DNA阳性是胎儿宫内感染HBV的高危因素.
목적탐토태인궁내을형간염병독(HBV DNA)감염적실험진단방법급기림상의의.방법응용매련면역흡부시험(ELISA)화형광정량취합매련반응(FQ-PCR)대156례을간표면항원(HBsAg)양성잉부적모혈화산후영인제혈급영인외주혈적을형간염혈청학표지물(HBV-M)화HBV DNA진행검측.결과156례HDsag양성잉부소생영인제혈화영인외주혈HBsAg적검출솔위8 3%(13/156)、6.4(10/156),HBeAg검출솔분별위7.1%(11/156)、5.1%(8/156),모혈、제혈、영인외주혈HBV DNA양성검출솔분별위36.5%(57/156)、28.2%(44/156)、23.7%(37/156);57례HBV DNA양성잉부혈병독함량(고패수/ml적대수치)위7.34±2.28,37례양성영인외주혈HBV DNA함량위6.08±0.96;여영인외주혈검측결과상비교,제혈중HBsag、HBeAg적양성솔불부존재23.1%화37.5%적가양성,HBV DNA야존재16.7%(7/42)적가양성;재HBeAg혹HBV DNA양성잉부중,영인외주혈HBV DNA적검출솔분별위73.8%(31/42)、64.9%(37/57),현저고우HBeAg혹HBV DNA음성자5.3%(6/114),(P＜0.01):영인외주혈중HBV DNA양성솔수잉부HBVDNA함량증가이현저증가(P＜0.005),기HBV DNA적함량여모혈정정상관,(r=0.39).결론영인제혈HBV검측시진단태인궁내HBV감염적사선지표,이영인외주혈적검측재구유학진의의;HBV DNA정량검측시태인궁내HBV감염화감염정도최위직접、민감적진단방법;잉부HBeAg、HBV DNA양성시태인궁내감염HBV적고위인소.
Objective:To explore the laboratory diagnostic methods in fetuses HBV infection and the clinical significance. Methods: Serologic HBV marks (HBVM) and HBV DNA in blood of 156 HBsAg( + ) pregnant women, cord blood and peripheral blood of neonates were detected by enzyme linked immunoadsorbent assay (ELISA) and fiuoresent quantitative polymerase chain reaction (FQ -PCR). Results: HBsAg positive rate of cord blood and peripheral blcod of the infants was 8.3% (13/156),6.4% (10/156),HBeAg positive rate was 7.1% (11/156),5.1% (8/156) respectively. HBV DNA positive rate was 36.5% (57/156) in maternal blood,28.2% (44/156)in cord blood,23.7% (37/156) in infants blood . 57 HBV DNA load of maternal blood was (7.34 ±2.28) ,37 infants blood was (6.08 ± 0. 96) ,their HBV DNA were all positive;Comparing with peripheral venous blood sample,HBsAg and HBeAg in cord blood existed false positive,HBV DNA existed 16.7% (7/42) false positive rate too;When HBeAg( + ) or HBV DNA( + ) in mothers blood ,HBV DNA positive rate of their infants blood was 73.8%(31/42) ,64.9% (37/57) respectively,which was significantly higher than mothers with HBeAg( - ) or HBV DNA(-) (P ＜0.01 ) . and it increased when HBV DNA load in mothers blood was increased (P ＜ 0.05 ),their HBV DNA load was positive correlated (r = 0.39 ). Conclusions: Cord blood may be impured by maternal blood, so detection of infants peripheral blood is with significance of making correct diagnosis; HBV DNA quantitative detection is regarded as a most direct,sensitive way in diagnosis of fetuese infection;HBeAg( + ) or HBV DNA( + ) in mothers is one of the high risk factors of intrauterine infection.