中华实验和临床感染病杂志（电子版）
中華實驗和臨床感染病雜誌（電子版）
중화실험화림상감염병잡지（전자판）
CHINESE JOURNAL OF EXPERIMENTAL AND CLINICAL INFECTIOUS DISEASES(ELECTRONIC VERSION)
2014年
3期
352-355
,共4页
肝炎病毒,乙型%母婴传播%新生儿%HBV标志物%HBV DNA
肝炎病毒,乙型%母嬰傳播%新生兒%HBV標誌物%HBV DNA
간염병독,을형%모영전파%신생인%HBV표지물%HBV DNA
Hepatitis B virus%Mother-to-child transmission%Hepatitis B virus markers%Hepatitis B virus deoxyribonucleic acid
目的：观察母亲血清HBV标志物（HBVM）及HBV DNA对新生儿静脉血HBVM的影响，探讨新生儿血清HBVM检测的临床意义。方法选择于本院分娩的HBsAg阳性母亲，根据其新生儿出生7个月后HBVM检测，分为HBV感染组和免疫成功组，对两组母亲及其新生儿的血清HBVM、HBV DNA及母婴传播情况进行回顾性分析。结果 HBV感染组和免疫成功组母亲HBeAg阳性率分别为97.1%和43.7%；HBV DNA阳性率分别为97.1%和16.2%。母亲血清HBV DNA水平越高，新生儿HBV感染率也越高（χ2=392.56，P＜0.0001）。HBV感染组新生儿出生时血清HBsAg、HBeAg、抗-HBe和HBV DNA的阳性率显著高于免疫成功组（P均＜0.0001）；尤其是HBV DNA，HBV感染组的新生儿出生时HBV DNA 100%为阳性，而410例免疫成功组新生儿仅1例出生时HBV DNA为阳性（3.67×103拷贝/ml）。在免疫成功组的新生儿中，HBsAg阳性率只有11.0%，HBeAg阳性率为34.9%，而免疫成功组和HBV感染组新生儿血清抗-HBc阳性率分别为98.8%和100%，两组差异无统计学意义（χ2=0.4317，P =0.663）。结论 HBV母婴阻断失败与母亲HBeAg阳性和HBV DNA水平有关。胎盘对HBV抗原及其抗体有选择的通透性，HBsAg不易透过胎盘，HBeAg可以部分透过胎盘进入胎儿体内，抗-HBc可以自由从母血中透过胎盘。新生儿出生时静脉血HBV DNA阳性和（或）HBsAg、HBeAg同时阳性可以预测新生儿的宫内感染和HBV免疫失败。
目的：觀察母親血清HBV標誌物（HBVM）及HBV DNA對新生兒靜脈血HBVM的影響，探討新生兒血清HBVM檢測的臨床意義。方法選擇于本院分娩的HBsAg暘性母親，根據其新生兒齣生7箇月後HBVM檢測，分為HBV感染組和免疫成功組，對兩組母親及其新生兒的血清HBVM、HBV DNA及母嬰傳播情況進行迴顧性分析。結果 HBV感染組和免疫成功組母親HBeAg暘性率分彆為97.1%和43.7%；HBV DNA暘性率分彆為97.1%和16.2%。母親血清HBV DNA水平越高，新生兒HBV感染率也越高（χ2=392.56，P＜0.0001）。HBV感染組新生兒齣生時血清HBsAg、HBeAg、抗-HBe和HBV DNA的暘性率顯著高于免疫成功組（P均＜0.0001）；尤其是HBV DNA，HBV感染組的新生兒齣生時HBV DNA 100%為暘性，而410例免疫成功組新生兒僅1例齣生時HBV DNA為暘性（3.67×103拷貝/ml）。在免疫成功組的新生兒中，HBsAg暘性率隻有11.0%，HBeAg暘性率為34.9%，而免疫成功組和HBV感染組新生兒血清抗-HBc暘性率分彆為98.8%和100%，兩組差異無統計學意義（χ2=0.4317，P =0.663）。結論 HBV母嬰阻斷失敗與母親HBeAg暘性和HBV DNA水平有關。胎盤對HBV抗原及其抗體有選擇的通透性，HBsAg不易透過胎盤，HBeAg可以部分透過胎盤進入胎兒體內，抗-HBc可以自由從母血中透過胎盤。新生兒齣生時靜脈血HBV DNA暘性和（或）HBsAg、HBeAg同時暘性可以預測新生兒的宮內感染和HBV免疫失敗。
목적：관찰모친혈청HBV표지물（HBVM）급HBV DNA대신생인정맥혈HBVM적영향，탐토신생인혈청HBVM검측적림상의의。방법선택우본원분면적HBsAg양성모친，근거기신생인출생7개월후HBVM검측，분위HBV감염조화면역성공조，대량조모친급기신생인적혈청HBVM、HBV DNA급모영전파정황진행회고성분석。결과 HBV감염조화면역성공조모친HBeAg양성솔분별위97.1%화43.7%；HBV DNA양성솔분별위97.1%화16.2%。모친혈청HBV DNA수평월고，신생인HBV감염솔야월고（χ2=392.56，P＜0.0001）。HBV감염조신생인출생시혈청HBsAg、HBeAg、항-HBe화HBV DNA적양성솔현저고우면역성공조（P균＜0.0001）；우기시HBV DNA，HBV감염조적신생인출생시HBV DNA 100%위양성，이410례면역성공조신생인부1례출생시HBV DNA위양성（3.67×103고패/ml）。재면역성공조적신생인중，HBsAg양성솔지유11.0%，HBeAg양성솔위34.9%，이면역성공조화HBV감염조신생인혈청항-HBc양성솔분별위98.8%화100%，량조차이무통계학의의（χ2=0.4317，P =0.663）。결론 HBV모영조단실패여모친HBeAg양성화HBV DNA수평유관。태반대HBV항원급기항체유선택적통투성，HBsAg불역투과태반，HBeAg가이부분투과태반진입태인체내，항-HBc가이자유종모혈중투과태반。신생인출생시정맥혈HBV DNA양성화（혹）HBsAg、HBeAg동시양성가이예측신생인적궁내감염화HBV면역실패。
Objectives To investigate the effect of mother’s serum HBV markers (HBVM) and HBV DNA on newborn venous blood HBVM, and to discuss the clinical signiifcance of newborn HBVM detection.Methods The mothers who deliveried at our hospital were divided into HBV-infected group and immune-success group according to the HBVM conditions of 7-month-old newborns. The newborn serum HBVM, HBV DNA and maternal-neonatal transmission situation between the two groups were analyzed, retrospectively.Results The HBeAg positive rates of HBV-infected group and immune-success group were 97.1% and 43.7%, respectively. The positive rates of HBV DNA were 97.1% and 16.2%, respectively. And the results also showed that the higher serum HBV DNA level of mothers, the higher HBV infection rate of newborn (χ2= 392.56,P < 0.0001). The positive rates of serum HBsAg, HBeAg, anti-HBe and HBV DNA in HBV-infected group were all higher than those in immune-success group. Specially, all of the newborns in HBV-infected group gave the 100% positive rate of HBV DNA, while there was only 1 positive case in immune-success group and the HBV DNA level was 3.67 × 103copies/ml. Among the immune-success newborns, the positive rates of HBsAg and HBeAg were 11.0% and 34.9%, respectively. The serum anti-HBc positive rates in HBV-infected group and immune-success group were 98.8% and 100%, respectively, with no signiifcant differences (χ2= 0.4317,P = 0.663).Conclusions Interdiction of maternal-neonatal transmission (PMTCT) failure is related to HBeAg positive and mother’s HBV DNA level. Placenta has selective permeability for HBV antigens and antibodies. It is dififcult for HBsAg to pass through placenta. HBeAg could partly across placenta into fetal body. Anti-HBc could across placenta from mother’s blood freely. The conditions of venous blood HBV positive and/or HBsAg-HBeAg double positive at birth might have predictive value for intrauterine infection and HBV immune failure of newborns.
