妊娠合并慢性乙肝患者HBV定量与新生儿宫内HBV感染的关系

doi:10.3969/j.issn.1671-7171.2022.02.025

摘要
图/表
参考文献(14)
相关文章 (15)

全文: PDF (1158 KB) HTML (1 KB)
输出: BibTeX | EndNote (RIS)

摘要【目的】探讨妊娠合并慢性乙型病毒性肝炎(简称为慢性乙肝)患者乙型肝炎病毒(HBV)定量与新生儿宫内HBV感染的关系。【方法】选取204例妊娠合并慢性乙肝患者,按照血清乙肝标志物分为携带组、大三阳组、小三阳组。对比分析三组妊娠合并慢性乙肝患者HBV定量、HBV阳性率、新生儿宫内HBV感染率及HBV定量和新生儿宫内HBV感染的关系。【结果】大三阳组妊娠患者血清和新生儿脐血HBV定量均大于小三阳组(P<0.05),且小三阳组大于携带组(P<0.05);大三阳组HBV阳性率和新生儿宫内HBV感染率均大于小三阳组
(P<0.01),且小三阳组HBV阳性率大于携带组(P<0.01);发生新生儿宫内HBV感染的妊娠患者年龄≥35岁、血清HBeAg阳性、血清HBV定量≥1000 copies/mL和胎儿窘迫均显著高于未发生新生儿宫内HBV感染者(P<0.05),抗病毒治疗比例低于未发生宫内HBV感染者(P<0.05)。 Logistic回归分析显示:年龄≥35岁、血清HBeAg阳性、血清HBV定量≥1000 copies/mL和胎儿窘迫均为新生儿宫内HBV感染的危险因素(P<0.05),抗病毒治疗是其保护因素(P<0.05)。【结论】妊娠合并慢性乙肝患者中大三阳患者具有更高的HBV传染性,年龄≥35岁、血清HBeAg阳性、血清HBV定量≥1000 copies/mL和胎儿窘迫均是妊娠合并慢性乙肝患者发生新生儿宫内HBV感染的危险因素。

	服务

	把本文推荐给朋友
	加入我的书架
	加入引用管理器
	E-mail Alert
	RSS
	作者相关文章
	李成梅
	江安珍

关键词 ：乙型肝炎,慢性, 妊娠, DNA,病毒/血液, 乙型肝炎病毒/遗传学疾病, 传染性疾病传播,垂直, 婴儿

Abstract：【Objective】To investigate the relationship between hepatitis B virus (HBV) quantitation and HBV intrauterine infection in patients with chronic hepatitis B complicated with pregnancy. 【Methods】A total of 204 cases of chronic hepatitis B patients with pregnancy were selected and divided into 3 groups according to the serum hepatitis B markers of pregnant women: carrying group, group A (HBsAg, HBeAg and HBcAb test positive) and group B (HBsAg, HBeAb and HBcAb test positive). The HBV quantitation, HBV positive rates, HBV intrauterine infection rates, and the relationships between HBV quantitation and HBV intrauterine infection were compared among the 3 groups. 【Results】Among the 3 groups, HBV quantitation in serum and umbilical cord blood of pregnant patients in the group A was higher than that in the group B (P<0.05), and that in the group B was higher than that in the carrier group (P<0.05). The HBV positive rate and HBV intrauterine infection rate in the group A were higher than those in the group B (P<0.01), and the HBV positive rate in the group B was higher than that in the carrier group (P<0.01). The proportion of HBV intrauterine infection in patients with chronic hepatitis B complicated with pregnancy who were older than or equal to 35 years old, serum HBeAg positive, serum HBV quantitation greater than or equal to 1000 copies/mL and fetal distress were higher than those without infection (P<0.05), and antiviral therapy was lower than those without infection (P<0.05). Logistic regression analysis confirmed that age older than or equal to 35 years old, serum HBeAg positive, serum HBV quantitative greater than or equal to 1000 copies/mL and fetal distress were risk factors of HBV intrauterine infection (P<0.05), and antiviral therapy was its protective factor (P<0.05). 【Conclusion】 Among the patients with chronic hepatitis B complicated with pregnancy, the patients with positive HBsAg, HBeAg and HBcAb had the highest HBV infectivity. Age over 35 years old, serum HBeAg positive, serum HBV level ≥1000 copies/mL and fetal distress are risk factors for intrauterine HBV infection in neonates with chronic hepatitis B complicated with pregnancy.

Key words： Hepatitis B,Chronic Pregnancy DNA,Viral/BL Hepatitis B virus/GE Infectious Disease Transmission,Vertical Infant

收稿日期: 2021-12-06

中图分类号:

R512.62

通讯作者: *E-mail:361700396@qq.com

引用本文:

李成梅, 江安珍. 妊娠合并慢性乙肝患者HBV定量与新生儿宫内HBV感染的关系[J]. 医学临床研究, 2022, 39(2): 248-251.
LI Cheng-mei, JIANG An-zhen. Relationship between HBV Quantitation and HBV Intrauterine Infection in Patients with Chronic Hepatitis B Complicated with Pregnancy. JOURNAL OF CLINICAL RESEARCH, 2022, 39(2): 248-251.

链接本文:

http://journal07.magtech.org.cn/yxlcyj/CN/10.3969/j.issn.1671-7171.2022.02.025 或 http://journal07.magtech.org.cn/yxlcyj/CN/Y2022/V39/I2/248

[1] 孙健, 王甦. 慢性乙肝患者PBMCs内AR mRNA,Era mRNA表达水平及其意义[J].医学临床研究, 2020, 37(5):693-695.
[2] 杨青青, 冯旭娇, 张中权, 等. 分娩方式对乙型肝炎病毒母婴垂直传播影响的Meta分析[J].中国妇幼保健, 2020, 35(2):195-200.
[3] LIU T, WAN Z, PENG S, et al. Genetic variations in LTA gene and PDCD1 gene and intrauterine infection of hepatitis B virus: a case-control study in China [J].Amino Acids,2018, 50(7):877-883.
[4] CHANG C Y, AZIZ N, POONGKUNRAN M, et al. Serum aminotransferase flares in pregnant and postpartum women with current or prior treatment for chronic hepatitis B [J].J Clin Gastroenterol,2018, 52(3):255-261.
[5] HOU J, CUI F, DING Y, et al. Management algorithm for interrupting mother-to-child transmission of hepatitis B virus [J].Clin Gastroenterol Hepatol,2019, 17(10):1929-1936.
[6] 张百田. 病毒性肝炎防治手册[M]. 北京:军事医学出版社, 1996:125-153.
[7] 秦惠基, 秦南雄. 乙型肝炎诊断与药物治疗[M]. 北京:金盾出版社, 2013:107-132.
[8] 郦爱贞. 乙肝病毒宫内感染临床诊断标准的探讨[J].中国妇幼保健, 2007, 22(4):475-477.
[9] TSAI K N, KUO C F, OU J J. Mechanisms of Hepatitis B Virus Persistence [J].Trends Microbiol,2018, 26(1):33-42.
[10] 陈文芹.260例乙型肝炎病毒感染孕妇母婴垂直传播中相关因素[J].中国妇幼保健, 2011, 26(23):3541-3542.
[11] 李祥, 胡超, 王太武, 等. HBV宫内感染危险因素的病例对照研究[J].重庆医学, 2017, 46(16):2187-2189.
[12] 王璐, 代晶芳, 张国梅. HBV高病毒载量孕妇与新生儿宫内HBV感染的相关性分析[J].中华医院感染学杂志, 2018, 28(4):586-589.
[13] 黄星, 黄燕, 韦业平, 等. 孕妇乙型肝炎病毒DNA含量及胎儿窘迫与宫内感染的关系[J].江苏医药杂志, 2004, 30(6):447-449.
[14] 陈莉, 周红, 温海燕, 等. HBV感染对单胎妊娠孕妇孕期围产结局的影响[J].中华医院感染学杂志, 2018, 28(3):455-458.