中文摘要：

目的 探讨胎盘凋亡及外周血单个核细胞（PBMC）母-胎转运与HBs Ag阳性孕妇新生儿PBMC HBs Ag的关系。方法 用等位基因特异性PCR（As-PCR）筛选母儿信息病例对,用原位末端杂交法检测HBs Ag阳性孕妇足月胎盘凋亡指数,用免疫荧光双标法检测新生儿PBMC涂片上的HBs Ag和谷胱甘肽S转移酶（GST）;采用SPSS 16.0软件进行分析。结果 86例新生儿PBMC中20例（23.26%）HBs Ag阳性,31例（36.05%）GST阳性,HBs Ag、GST共存者13例（15.12%）;发生PBMC母-胎转运组的胎盘凋亡指数与未发生转运组的胎盘凋亡指数差异有统计学意义（t＇=2.38,P=0.02）,且胎盘滋养层细胞凋亡率高与PBMC转运相关（t=2.75,P=0.01）;新生儿PBMC HBs Ag阳性组的胎盘细胞凋亡指数与阴性组的胎盘细胞凋亡指数差异无统计学意义（t=0.34,P=0.74）;PBMC转运与新生儿PBMC HBs Ag阳性有关（χ^2=9.48,P=0.00）,发生PBMC转运的新生儿发生PBMC HBs Ag阳性的危险性是未发生PBMC转运新生儿的4.95倍（OR=4.95,95%CI=1.70~14.39）。结论 妊晚期胎盘细胞凋亡增加有利于PBMC母-胎转运,感染HBV的PBMC可能通过胎盘进入胎儿血循环进而导致新生儿HBV感染。

英文摘要：

Objective To explore the relationship between placental apoptosis, peripheral blood mononuclear cell （PBMC） transfer from mother to baby and hepatits B virus surface antigen（HBsAg） of PBMC in the neonates born to HBsAg positive pregnant women. Methods Mother-baby pairs were screened with allele-specific PCR（ As-PCR）. Temi- nal deoxy nucleotidyl transferase（TdT-） mediated dUTP nick end labeling（TUNEL） method was used to detect placenta apoptosis index of HBsAg-positive full term pregnant women. Immunofluorescence double labeling method was used to detect HBsAg and glutathione S transferase（GST） in neonatal PBMC smear samples. Statistical analysis was performed by using SPSS 16.0. Results Of 86 neonatal PBMC smear samples ,20（23.30% ） were HBsAg positive,31 （ 36.00% ） were GST positive, and 13 （ 15.12 % ） were both HBsAg positive and GST positive （ 15.12 % ）, respectively. The placental cell apoptosis index was significantly different between the pregnant women with and without PBMC transfer（ t＇ = 2. 38, P = 0. 02）, and the rate of apoptosis in placetal trophoblast cells and PBMC transfer was related （ t = 2.75, P = 0. 01 ）. Placental apoptosis index between PBMC HBsAg positive and negative neonates was not significantly different（ t = 0. 34, P = 0.74）. There was a correlation between PBMC transfer from mother to baby and HBsAg positive of PBMC in neo- nates（x^2 =9. 48,P = 0. 00）, and the risk of HBsAg positive of PBMC in the neonates with PBMC transfer was 4. 95 （95% confidence interval：1. 70-14. 39）times higher than in the neonates without PBMC transfter. Conclusion Placental apoptosis may increase placental permeability during late pregnancy, which is beneficial to the mother-baby transfer of PBMC. PBMC infected with HBV may pass into fetal blood circulation through placenta and induce HBV infection in neonates.