乙肝携带产妇血清、乳汁及新生儿血清中HBV DNA载量的关系探讨

摘要

目的 探讨乙型肝炎病毒携带产妇血清及乳汁中HBV DNA载量与新生儿血清中HBV DNA载量的关系,以指导临床采取正确的孕期处理和母乳喂养措施.方法 选择乙型肝炎病毒携带产妇293例,采用荧光定量PCR技术测定产妇血清、母乳和新生儿血清HBV DNA载量,并将产妇血清HBV DNA载量分为血清阴性组(HBV DNA＜103 copies/mL)、血清低拷贝组(103 copies/mL≤HBV DNA≤106 copies/mL)和血清高拷贝组(HBV DNA＞106copies/mL),并按标本类型和HBV DNA水平进行比较.结果 293例HBV感染产妇中,HBV DNA阴性组、低拷贝组和高拷贝组分别占50.2％ 、21.8％和28.0％.血清HBV DNA阴性组产妇乳汁中HBV DNA检出率为0.而血清低拷贝组和高拷贝组产妇乳汁HBV DNA的阳性检出率分别为12.5％和76.8％,前者明显低于后者(P＜0.01).而血清HBVDNA阴性组、低拷贝组和高拷贝组之间新生儿血清HBV DNA阳性率差异均无统计学意义(P＞0.05).结论 产妇血清中HBV DNA载量与乳汁中HBV DNA阳性率呈正相关.产妇血清HBV DNA载量与胎儿宫内感染无明显相关性.%Objective To discuss the correlation between HBV DNA in serum, breast milk of HBV-earring parturient women and the one in serum of newborn for supplying a correct clinic guidance of pregnancy management and breast feeding measures. Methods HBV DNA in serum, breast milk of HBV-earring parturient women (n=293) and serum of newborn were detected by fluorescence quantitative PCR. 293 cases of parturient women were divided into three groups according to HBV DNA load: serum negative group (HBV DNA<103 copies/mL), serum low copies group (103 copies/mL≤ HBV DNA≤106 copies/mL) and serum high copies group (HBV DNA>106copies/mL). Then a comparision between them was carried out. Results In 293 cases of HBV-carring parturient women, HBV DNA negative group, low copies group and high copies group account for 50.2%, 21.8% and 28.0% respectively. The positive rate for detection of HBV DNA in breast milk in serum negative group was 0. But in serum low copies group and high copies group, the detection rate was 12.5% and 76.8% respectively. The former was significantly higher than the latter (P < 0.01). The HBV DNA positive rate of the newborn serum showed no significant difference among the three groups (P > 0.05). Conclusion The HBV DNA copies in the parturient women is correlated with HBV DNA positive rate in breast milk. The HBV DNA copies in the parturient women is not correlated with fetal intrauterine infection.