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目的探讨孕妇乙型肝炎血清学感染模式与新生儿宫内感染的相关性。方法 ELISA法检测孕妇血清乙型肝炎病毒血清学标志物(HBV-M),HBsAg、HBeAg、HBeAb、HBcAb任一项阳性者,荧光定量PCR法检测脐血HBV-DNA。根据HBV-M不同模式将结果分为HBeAg(+)组、HBsAg(+)HBeAg(-)组、HBsAg(-)HBeAg(-)三组,比较各组脐血HBV-DNA阳性检出率及HBV-DNA定量结果。结果 722例受检孕妇中,93例脐血HBV-DNA检出阳性,阳性检出率为12.9%,HBeAg(+)组阳性检出率显著高于其它二组(P<0.001);三组脐血HBV-DNA对数均值分别为(4.85±1.29)、(4.35±0.98)和(3.75±0.40),HBeAg(+)组脐血DNA含量显著高于其它二组(P<0.001)。结论孕妇血清HBeAg(+)者新生儿宫内感染率较高,孕妇血清HBsAg(-)HBeAg(-)者新生儿亦存在宫内感染的可能性。
Objective To investigate the correlation between hepatitis B seroprevalence and neonatal intrauterine infection in pregnant women. Methods Serum HBV-M, HBsAg, HBeAg, HBeAb and HBcAb were detected by ELISA in pregnant women, HBV-DNA was detected by fluorescence quantitative PCR. According to the different patterns of HBV-M, the results were divided into three groups: HBeAg (+), HBsAg (+) HBeAg (-) and HBsAg (-) HBeAg HBV-DNA quantitative results. Results The positive rate of HBV-DNA in 93 cord blood samples was found to be 12.9% in 722 pregnant women, the positive rate of HBeAg (+) was significantly higher than that of the other two groups (P <0.001) The logarithmic mean values of HBV-DNA in cord blood were (4.85 ± 1.29), (4.35 ± 0.98) and (3.75 ± 0.40), respectively. The content of DNA in cord blood of HBeAg (+) group was significantly higher than that in other two groups (P <0.001). Conclusions The serum HBeAg (+) in pregnant women has a high intrauterine infection rate in newborns, and the possibility of intrauterine infection also exists in newborns with serum HBsAg (-) HBeAg (-) in pregnant women.