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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HB-sAg、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。
Objective To investigate the clinical significance of hepatitis B virus markers in neonates with hepatitis B virus surface antigen (HBsAg) positive mothers. Methods From 1999-07-2002-06, 996 newborns in the pediatrics department of Beijing Ditan Hospital were tested for venous hepatitis B virus markers on the third day after birth and 199 cases were observed to grow to 3 months to 4 years old. The HBsAg and HBeAg analysis. Results The positive rates of HBsAg and HBeAg on the third day after birth were 27.2% (271/996) and 48.1% (479/996), respectively. The positive rate of anti-HBc in 495 cases was 99.2% (491/495). During the period of 3 months to 4 years after birth, the hepatitis B virus markers were retrospectively studied in 199 cases, of which 17 cases were infected with hepatitis B virus, accounting for 8.5% (17/199). The HBsAg titers of HBsAg and HBeAg in newborns infected with hepatitis B virus were higher than those in non-infected neonates (P <0.01) on the 3rd day after birth, while the difference in HBeAg titer was not significant (P> 0.05) . The serum HBsAg and HBeAg titers in infected and non-infected children were compared with those in the third day after birth respectively. The serum HBsAg and HBeAg titers in 17 infected children were significantly higher (P <0.001, P <0.05) , While 182 uninfected children were significantly lower (P <0.001). Conclusion Serum HBsAg, HBeAg and anti-HBc positive in neonates with HBsAg positive pregnant women can not be used as the basis for diagnosing hepatitis B virus infection. Serum HBsAg titers are higher in neonates and increase gradually 3 months after birth, which can be used as a marker of hepatitis B virus Diagnosis basis.