乙型肝炎病毒母婴传播问题探讨

探讨乙型肝炎病毒宫内感染及乳汁感染的母婴传播问题，用聚合酶链反应（ＰＣＲ）技术对７５例ＨＢｓＡｇ阳性产妇初乳及其新生儿外周血进行ＨＢＶ ＤＮＡ的检测；同时应用酶联免疫吸附法（ＥＬＩＳＡ）测定产妇初乳中乙肝病毒５项标志物（ＨＢＶＭ）。结果为１）１７５例初乳中ＨＢＶ ＤＮＡ阳性率为６８％，高于同组新生儿外周血ＨＢＶ ＤＮＡ阳性率３４．６７％，有显性差（Ｐ〈０．０１）；ＨＢＶＭ三项阳性各组二埂有显性差异（Ｐ〈０．０５）．２）ＨＢｅＡｇ阳性初乳及新生儿外周血ＨＢＶ ＤＮＡ阳性率均量高，与ＨＢｓＡｇ、抗－ＨＢｃ比较，有显性差异（Ｐ〈０．０１，Ｐ〈０．０５）。表明初乳排毒率高于内传染率，母婴传播率与母血中ＨＢＶＭ传染性呈正相关。

A Study on the Materal-Fetal Transmisson of Hepatitis B Virus

To study on the maternalfetal transmission of hepatitis B virus via uterine and colostrum. Polymerase chain reaction (PCR) was used for detection of HBVDNA in colostrum of 75 HBsAg positive puerperants, blood of their neonates. Five markers of HBV (HBVM) were examined by enzymelinked immunosorbent assay (ELISA) in colostrum. The detective rate of HBVDNA was 68% in colostrum of 75 HBsAg positive puerperant, significantly higher than that was of their neonates whose infection rate was 34.67% in blood (P<0.01).The results were similar when HBsAg, HBeAg and antiHBc or HBsAg, antiHBe and antiHBc were positive simultaneously (P<0.05). In HBeAgpositive puerperant there were significantly higher infection rate of HBV DNA in their colostrum and the blood of their neonates than that in HBeAg negative (P<0.05). Among the HBVM, the rate of HBeAg positive was the highest, which was significantly different from that of HBsAg and anti HBc in the colostrum of 75 cases. Our conclusion is that expelling of toxin rate of colostrum is higher than the rate of intraterine infection and there is positive correlation between maternalfetal transmission rate and HBVM infectivity of pregnant women.