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目的:探讨HBV垂直传播状况、细胞分子机制及其对胎儿的影响。方法:将46例HBV感染孕妇按HBeAg(+)和HBeAg(-)进行分组,以PCR法对46例HBV感染孕妇产前血清及外周血单个核细胞(PBMC)中HBV-DNA进行检测,并对新生儿脐血血清及脐血单个核细胞(CBMC)中HBV-DNA进行检测,同时选取10例健康孕妇为正常对照。结果:HBV感染孕妇血清及PBMC中HBV-DNA的阳性率分别为69.57％(32/46)和41.30％(19/46),分娩时新生儿脐血血清及CBMC中HBV-DNA的阳性率分别为56.52％(26/46)和21.74％(10/46)。其中HBeAg(+)组孕妇血清及PBMC中HBV-DNA的阳性率分别为100.00％(25/25)和60.00％(15/25);分娩时新生儿脐血血清及CBMC中HBV-DNA的阳性率分别为88.00％(22/25)和32.00％(8/25)。HBeAg(-)组孕妇血清及PBMC中HBV-DNA的阳性率分别33.33％(7/21)和19.05％(4/21),分娩时新生儿脐血血清及CBMC中HBV-DNA的阳性率分别为19.05％(4/21)和9.52％(2/21)。两者相比差异有显著性(P<0.01和P<0.05)。健康孕妇血清、PBMC及其所分娩新生儿脐血血清、CBMC中均未检出HBV-DNA。结论:HBV确可经胎盘垂直传播,其传播途径可通过直接传播,亦可通过PBMC介导,PBMC介导的HBV垂直传播较隐匿,HBeAg(+)孕妇发生HBV垂直传播的危险性高。
Objective: To investigate the vertical transmission of HBV, cellular and molecular mechanisms and their effects on the fetus. Methods: Forty-six HBV infected pregnant women were divided into two groups according to HBeAg (+) and HBeAg (-). HBV-DNA in prenatal serum and peripheral blood mononuclear cells (PBMCs) from 46 HBV infected pregnant women were detected by PCR. HBV-DNA in neonatal umbilical cord blood and cord blood mononuclear cells (CBMC) were detected, and 10 healthy pregnant women were selected as normal control. Results: The positive rates of HBV-DNA in serum and PBMC of HBV infected pregnant women were 69.57% (32/46) and 41.30% (19/46), respectively. The positive rates of HBV-DNA in neonatal cord blood and CBMC during childbirth were respectively 56.52% (26/46) and 21.74% (10/46) respectively. The positive rates of HBV-DNA in serum and PBMC from HBeAg (+) group were 100.00% (25/25) and 60.00% (15/25) respectively. The positive rates of HBV-DNA in neonatal cord blood and CBMC during childbirth Rates were 88.00% (22/25) and 32.00% (8/25), respectively. The positive rates of HBV-DNA in serum and PBMC of HBeAg (-) group were 33.33% (7/21) and 19.05% (4/21) respectively. The positive rates of HBV-DNA in neonatal cord blood and CBMC during childbirth were 19.05% (4/21) and 9.52% (2/21) respectively. The difference between the two groups was significant (P <0.01 and P <0.05). Healthy pregnant women serum, PBMC and its birth of neonatal cord blood serum, CBMC were not detected HBV-DNA. Conclusion: HBV can indeed spread vertically through the placenta. The route of transmission can be transmitted directly or through PBMCs. The vertical transmission of PBMCs is more hidden than that of PBMCs, and the HBV carriers are at high risk of transmitting HBV vertically.