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目的探讨HBV宫内感染的传播途径及其机理。方法应用PCR技术检测HBV感染孕妇羊水、阴道分泌物、乳汁、脐血中HBV DNA;免疫组织化学技术检测胎盘组织中HBsAg和HBcAg的表达。结果HBsAg、HBeAg、抗HBc阳性孕妇的羊水、阴道分泌物、乳汁、脐血中均检测到了HBV DNA,阳性率分别为48.28%(14/29)、27.59%(8/29)、37.93%(11/29)和24.14%(7/29);健康对照组孕妇的上述样品中均未检出HBV DNA;HBV感染孕妇胎盘组织各层细胞均可表达两种抗原,但阳性细胞数目从母体面到胎儿面逐渐减少,阳性细胞的着色强度逐渐减弱。健康对照组孕妇胎盘组织中未发现HBsAg和HBcAg阳性染色细胞。结论孕妇感染HBV后可通过多种途径传播,而羊水感染是导致胎儿感染的重要传播途径。
Objective To investigate the transmission and mechanism of HBV intrauterine infection. Methods The HBV DNA in amniotic fluid, vaginal secretions, breast milk and umbilical cord blood of pregnant women with HBV infection was detected by PCR. The expression of HBsAg and HBcAg in placenta was detected by immunohistochemistry. Results HBV DNA was detected in amniotic fluid, vaginal secretions, breast milk and umbilical cord blood of HBsAg, HBeAg and anti-HBc positive pregnant women, the positive rates were 48.28% (14/29), 27.59% (8/29) and 37.93% 11/29) and 24.14% (7/29), respectively. No HBV DNA was detected in the pregnant women in the healthy control group. Two antigens were expressed in the placenta of HBV infected pregnant women, Gradually decreased to the fetus, the staining intensity of positive cells gradually weakened. No HBsAg and HBcAg positive cells were found in the placenta of healthy pregnant women. Conclusion Pregnant women can be transmitted through a variety of ways after infection with HBV, and amniotic fluid infection is an important route of transmission leading to fetal infection.