摘要
目的探讨和分析孕早期胎盘HBV感染的相关危险因素。方法选取2018年1~12月在杭州市萧山区第一人民医院进行人工流产术的253例孕妇及其胎盘作为研究对象。采用酶联免疫吸附法(ELISA)检测孕妇血清中HBsAg、抗-HBs、HBeAg、抗-HBe和抗-HBc;采用巢式PCR扩增法检测孕妇血清中HBV DNA载量;采用免疫组化链霉亲和素-生物素复合物法(SABC)检测孕妇胎盘中的HBsAg和HBcAg。结果 253例孕早期流产孕妇中,HBsAg阳性孕妇24例,阳性率为9.49%,其中,流产胎盘感染9例,感染率37.50%。HBsAg阳性孕妇不同类型胎盘感染阳性率:蜕膜细胞(decidual cell,DC)占33.33%(8/24),滋养层细胞(trophoblast cell,TC)占29.17%(7/24),绒毛间质细胞(villous stromal cell,VMC)占25.00%(6/24),绒毛毛细血管内皮细胞(villi capillary erdothelial cell,VCEC)占12.50%(3/24)。经logistic回归分析,HBeAg阳性和HBV DNA浓度>10~4 IU/ml是孕早期胎盘HBV感染的独立危险因素(P=0.013、0.037)。结论 HBeAg阳性和HBV DNA浓度过高是孕早期胎盘HBV感染的独立危险因素,孕妇外周血HBeAg转阴,降低HBV DNA载量等措施,对于减少胎儿HBV宫内感染具有十分重要的临床意义。
Objective To analyze the risk factors of placental HBV infection in early pregnancy. Methods Blood samples and decidual tissues were collected from 253 pregnant women underwent induced abortion in Xiaoshan hospital from January to December 2018.Serum HBsAg, anti-HBs, HBeAg, anti-HBe and anti-HBc were detected by enzyme-linked immunosorbent assay(ELISA). Serum HBV DNA load was determined by nested PCR.HBsAg and HBcAg in placenta were detected by immunohistochemistry streptavidin-biotin complex(SABC). Results 24 out of 253 pregnant women were HBsAg positive with the positive rate of 9.49%, of which 9 had placental HBV infection with the infection rate of 37.50%.The placental HBsAg positive rates of DC, TC, VMC and VCEC were 33.33%(8/24), 29.17%(7/24), 25.00%(6/24) and 12.50%(3/24), respectively.Logistic regression analysis showed that HBeAg positive and HBV DNA concentration of >10~4 IU/ml were independent risk factors for placental HBV infection in early pregnancy(P=0.013, 0.037). Conclusions HBeAg positive and high HBV DNA level are independent risk factors for placental HBV infection in early pregnancy.Therefore, sero-conversion of peripheral blood HBeAg of pregnant women and reducing HBV DNA concentration are important interventions to lower the risk of fetal HBV intrauterine infection.
作者
赵红萍
周鸿良
王悦
ZHAO Hong-ping;ZHOU Hong-liang;WANG Yue(Department of Obstetrics,First People′s Hospital of Xiaoshan District,Hangzhou,Zhejiang 311200,China)
出处
《中国预防医学杂志》
CAS
CSCD
2019年第9期858-861,共4页
Chinese Preventive Medicine
