首页> 中文期刊> 《中华临床感染病杂志》 >脐带血和母亲血清乙型肝炎病毒标志物的关系

脐带血和母亲血清乙型肝炎病毒标志物的关系

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Objective To investigate the correlation of hepatitis B virus (HBV) markers between umbilical cord blood and maternal serum.Methods A total of 340 HBsAg positive mothers who delivered at the Third People' s Hospital of Changzhou during August 2009 and November 2010 were included in the study.HBV markers in the maternal serum before childbirth and umbilical cord blood after birth were quantitatively detected.The neonates received 3 doses of hepatitis B vaccine and 2 doses of hepatitis B immunoglobulin (HBIG),and followed up for 12 months.Measurement data were expressed as median (M),and Kruskal-Wallis test and Spearman correlation analysis were performed.Results There were 175HBeAg-positive and 165 HBeAg-negative mothers,and a total of 341 infants were delivered.The positive rates of HBsAg,anti-HBs,HBeAg,anti-HBe and anti-HBc in maternal serum were 100.00%,0.0%,51.47%,38.82% and 99.41%,respectively; while those in umbilical cord bloods were 14.66%,0.59%,26.69%,39.88% and 95.31%,respectively.HBsAg concentration in maternal serum of HBsAg-positive umbilical cord blood group was higher than that of HBsAg-negative umbilical cord blood group (419.40∶ 387.95,x2 =4.592,P < 0.05) ; while HBsAg concentration in umbilical cord blood of HBeAg-positive maternal serum was higher than that of the HBeAg-negative maternal serum group (0.04 ∶ 0.01,x2 =5.674,P < 0.05).Anti-HBe and anti-HBc in umbilical cord blood were positively correlated with those in maternal serum (r =0.838,0.764,P < 0.01).Seven out of 62 (11.29%) infants were infected with HBV in HBeAg-positive maternal serum group; while no infant infected in HBeAg-negative matemal serum group.Conclusion The higher maternal serum HBsAg concentration,the greater the risk of perinatal transmission,and infants born by HBeAg-positive mothers are of high risk of HBV infection.%目的 探讨脐带血与母亲血清乙型肝炎病毒(HBV)标志物的关系.方法 选择2009年8月至2010年1 1月在江苏省常州市第三人民医院住院分娩的340例HBsAg阳性母亲,定量检测分娩前母亲血清和分娩后脐带血HBV标志物.新生儿接受3剂乙型肝炎疫苗和2剂高效价乙型肝炎免疫球蛋白(HBIG),随访至12月龄.计量资料用中位数(M)表示,组间比较采用Kruskal-Wallis检验,相关性分析用Spearman秩相关.结果 340例HBsAg阳性母亲中HBeAg阳性175例,HBeAg阴性165例,共分娩新生儿341名.母亲血清HBsAg、抗-HBs、HBeAg、抗-HBe和抗-HBc阳性率分别为100.00%,0,51.47%,38.82%和99.41%,脐带血分别为14.66%,0.59%,26.69%,39.88%和95.31%.脐带血HBsAg阳性组母亲血清HBsAg浓度明显高于脐带血HBsAg阴性组的母亲(419.40∶387.95,x2=4.592,P<0.05),母亲血清HBeAg阳性组脐带血HBsAg浓度明显高于母亲血清HBeAg阴性组脐带血(0.04∶0.01,x2=5.674,P<0.05).脐带血抗-HBe与抗-HBc水平分别与母亲血清中抗-HBe与抗-HBc的水平呈正相关(r=0.838和0.764,P值均<0.01).随访婴儿至12月龄时,血清HBeAg阳性母亲所生婴儿的HBV感染率为11.29%(7/62),血清HBeAg阴性母亲所生婴儿无HBV感染.结论 母亲血清HBsAg浓度越高发生母婴传播的可能性越大,HBeAg阳性母亲的孩子感染HBV的风险高.

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