实用肝脏病杂志
實用肝髒病雜誌
실용간장병잡지
JOURNAL OF CLINICAL HEPATOLOGY
2014年
4期
376-379
,共4页
冯振华%张姝%刘景丽%毕永春%夏挺%许碧云%胡娅莉%周乙华
馮振華%張姝%劉景麗%畢永春%夏挺%許碧雲%鬍婭莉%週乙華
풍진화%장주%류경려%필영춘%하정%허벽운%호아리%주을화
乙型肝炎病毒携带者%孕妇%HBeAg血清学转换%HBsAg血清学清除
乙型肝炎病毒攜帶者%孕婦%HBeAg血清學轉換%HBsAg血清學清除
을형간염병독휴대자%잉부%HBeAg혈청학전환%HBsAg혈청학청제
Hepatitis B virus carrier%Pregnant women%HBeAg seroconversion%HBsAg seroclearance
探讨影响慢性乙型肝炎病毒（HBV）携带孕妇产后自发HBeAg和HBsAg血清清除或转换的相关病毒学特征。方法2002年8月～2004年7月本院诊断的慢性HBV携带孕妇，自2009年10月～2010年3月间随访，检测HBV血清学标志和病毒相关特性。结果在本组419例慢性HBV携带孕妇中，经随访平均6.4年，失访155例。在接受随访的264例（63.0%）中，76例（28.8%）孕期在入组时HBeAg阳性，其中42例（55.3%）随访时发生自发HBeAg转换,这些孕妇孕期HBV DNA、HBeAg 和HBsAg均低于34例未转换组（P值均<0.01）。在6例血清HBV DNA <1×106 IU/ml、17例HBeAg <700 S/CO和13例HBsAg <1×104 IU/ml孕妇中，随访时自发HBeAg转换分别高达100.0%、100.0%和92.3%。随访时，38例（14.4%）孕妇自发HBsAg清除，HBsAg清除组孕期HB-sAg水平明显低于226例未清除组（P<0.001）。在25例血清HBsAg <100 IU/mL孕妇中，随访时56.0%自发HBsAg清除。结论外周血HBV DNA载量低（<1×106 IU/ml）、HBeAg水平低（<700 S/CO）或HBsAg水平低（<1×104 IU/ml）是自发HBeAg血清转换的有利因素，而当HBsAg <100 IU/mL时，更易发生自发HBsAg血清清除。
探討影響慢性乙型肝炎病毒（HBV）攜帶孕婦產後自髮HBeAg和HBsAg血清清除或轉換的相關病毒學特徵。方法2002年8月～2004年7月本院診斷的慢性HBV攜帶孕婦，自2009年10月～2010年3月間隨訪，檢測HBV血清學標誌和病毒相關特性。結果在本組419例慢性HBV攜帶孕婦中，經隨訪平均6.4年，失訪155例。在接受隨訪的264例（63.0%）中，76例（28.8%）孕期在入組時HBeAg暘性，其中42例（55.3%）隨訪時髮生自髮HBeAg轉換,這些孕婦孕期HBV DNA、HBeAg 和HBsAg均低于34例未轉換組（P值均<0.01）。在6例血清HBV DNA <1×106 IU/ml、17例HBeAg <700 S/CO和13例HBsAg <1×104 IU/ml孕婦中，隨訪時自髮HBeAg轉換分彆高達100.0%、100.0%和92.3%。隨訪時，38例（14.4%）孕婦自髮HBsAg清除，HBsAg清除組孕期HB-sAg水平明顯低于226例未清除組（P<0.001）。在25例血清HBsAg <100 IU/mL孕婦中，隨訪時56.0%自髮HBsAg清除。結論外週血HBV DNA載量低（<1×106 IU/ml）、HBeAg水平低（<700 S/CO）或HBsAg水平低（<1×104 IU/ml）是自髮HBeAg血清轉換的有利因素，而噹HBsAg <100 IU/mL時，更易髮生自髮HBsAg血清清除。
탐토영향만성을형간염병독（HBV）휴대잉부산후자발HBeAg화HBsAg혈청청제혹전환적상관병독학특정。방법2002년8월～2004년7월본원진단적만성HBV휴대잉부，자2009년10월～2010년3월간수방，검측HBV혈청학표지화병독상관특성。결과재본조419례만성HBV휴대잉부중，경수방평균6.4년，실방155례。재접수수방적264례（63.0%）중，76례（28.8%）잉기재입조시HBeAg양성，기중42례（55.3%）수방시발생자발HBeAg전환,저사잉부잉기HBV DNA、HBeAg 화HBsAg균저우34례미전환조（P치균<0.01）。재6례혈청HBV DNA <1×106 IU/ml、17례HBeAg <700 S/CO화13례HBsAg <1×104 IU/ml잉부중，수방시자발HBeAg전환분별고체100.0%、100.0%화92.3%。수방시，38례（14.4%）잉부자발HBsAg청제，HBsAg청제조잉기HB-sAg수평명현저우226례미청제조（P<0.001）。재25례혈청HBsAg <100 IU/mL잉부중，수방시56.0%자발HBsAg청제。결론외주혈HBV DNA재량저（<1×106 IU/ml）、HBeAg수평저（<700 S/CO）혹HBsAg수평저（<1×104 IU/ml）시자발HBeAg혈청전환적유리인소，이당HBsAg <100 IU/mL시，경역발생자발HBsAg혈청청제。
Objective To study the virologic determinants of spontaneous seroclearance or seroconversion of HBeAg and/or HBsAg in pregnant women who are chronic hepatitis B virus (HBV) carriers. Methods The pregnant women diagnosed as chronic HBV carriers between August,2002 and July,2004 were included and fol-lowed up between October,2009 and March,2010. The HBV serologic markers and HBV DNA were detected. Results A total of 419 individuals were recruited in this study,and the average follow-up period was 6.4 years. Although 155 women lost,a total of 264(63.0%) women were successfully followed up,of whom 76 (28.8%) were HBeAg-positive at presentation. 55.3%(42/76) of HBeAg-positive women were seroconverted to anti-HBe sponta-neously at the follow-up. Compared with 34 women without seroconversion,42 with HBeAg/anti-HBe seroconver-sion had lower levels of serum HBV DNA,HBeAg and HBsAg(all P﹤0.01). The postpartum HBeAg seroconversion rate in 6 pregnant women with HBV DNA ﹤1×106 IU/ml,17 with HBeAg ﹤700 S/CO,and 13 with HBsAg﹤1×104 IU/ml were 100.0%,100.0% and 92.3%,respectively. The spontaneous HBsAg seroclearance was found in 38 (14.4%) women at the follow-up. The serum HBsAg levels at presentation were significantly lower in women with HBsAg seroclearance than 226 without HBsAg seroclearance (P﹤0.001). The postpartum HBsAg seroclearance rate in 25 pregnant women with HBsAg ﹤100 IU/ml was as high as 56.0%. Conclusions HBeAg-positive women with serum HBV DNA ﹤1 ×106 IU/ml,HBeAg ﹤700 S/CO and/or HB-sAg ﹤1×104 IU/ml are more likely to undergo spontaneous HBeAg seroconversion,and those with serum HBsAg ﹤100 IU/ml have a higher chance of spontaneous HBsAg sero-clearance.
