中文摘要：

目的探讨HBsAg阳性孕妇胎盘HBsAg与新生儿HBV血清学标志物和HBVDNA的关系。方法免疫组织化学亲和素一生物素复合物（ABC）法检测155例HBsAg阳性孕妇的胎盘HBsAg，ELISA法检测新生儿HBV血清学标志物，荧光定量PCR法检测新生儿血清HBVDNA。各指标阳性率的比较采用y。检验。结果155例孕妇的胎盘各型细胞均存在不同程度的HBsAg阳性表达，总的胎盘HBsAg阳性58份，阳性率为37．4％；蜕膜细胞、滋养层细胞、绒毛间质细胞和绒毛毛细血管内皮细胞HBsAg阳性各有58、40、29和11份，阳性率分别为37．4％、25．8％、18．7％和7．1％；胎盘从母体面的蜕膜细胞至胎儿面的绒毛毛细血管内皮细胞HBsAg阳性率逐渐下降（趋势X2=43．01，P=0．00）。胎盘HBsAg阳性与新生儿HBsAg、HBeAg阳性均有关（X2=4．88，P〈0．05；X2=3．86，P〈0．05），而与新生儿抗-HBe、抗-HBc无关（X2=3．36，P〉0．05；7X2=0．00，P〉0．05）。胎儿面的绒毛毛细血管内皮细胞和绒毛间质细胞HBsAg阳性时，新生儿HBsAg阳性的危险性高（OR=5．31，95％CI：1．38～20．40；OR=3．33，95％CI：1．16～9．52）；而滋养层细胞和绒毛间质细胞HBsAg阳性时，新生儿HBeAg阳性的危险性较大（OR=3．04，95％Ct：1．45～6．39；OR=3．05，95％CI：1．32～7．03）；胎盘HBsAg阳性与新生儿HBVDNA阳性无关（X2=0．09，P〉0．05）。结论越接近胎儿面的胎盘细胞HBsAg表达阳性，新生儿HBV血清学标志物阳性的危险性越大。HBsAg在胎盘中以“逐层转移”的方式进入胎儿血循环。

英文摘要：

Objective To study the relationship between placenta HBsAg in HBsAg positive pregnant women and serum hepatitis B virus （HBV） markers, HBV DNA levels in newborns. Methods Placenta HBsAg was detected by immunohistochemical affinity hormone-biotin complex （ABC） method in 155 HBsAg positive pregnant women. Serum HBV markers in newborns were detected by enzyme-linked immunosorbent assay （ELISA）. Serum HBV DNA levels of newborns were detected by real-time fluorescence quantitative polymerase chain reaction （PCR）. The positive rates were compared using X2 test. Results HBsAg was expressed with different levels in various types of cells of placenta in 155 pregnant women. The total placenta HBsAg positive rate was .37.4% （58/155）, and those in decidual cells, trophoblastic cells, villous mesenchymal cells and villous capillary endothelial cells were 37.4% （58/155）, 25.8% （40/155）, 18. 7% （29/155） and 7. 1M（11/155）, respectively. The HBsAg positive rates of placenta gradually decreased from decidual cells of the maternal surface to villous capillary endothelial cells of the fetal surface （tendency X2 = 43.01, P= 0.00）. The positivity of placenta HBsAg was associated with both HBsAg and HBeAg in newborns （X2=4.88, P〈0.05 and X2=3.86, P〈0.05, respectively）, while that was not associated withanti-HBe and anti-HBc in newborns （Z2 = 3.36, P〉0.05 and X2 = 0.00, P〉0.05, respectively）. The risk of HBsAg positive in newborns was higher when HBsAg was positive in villous capillary endothelial cells and villous mesenchymal cells （OR=5.31, 95%CI=1. 38-20. 40 and OR= 3.33, 95 % CI= 1.16-9.52, respectively）. The risk of HBeAg positive in newborns was higher when HBsAg was positive in trophoblastic cells and villous mesenchymal cells （OR= 3.04, 95 %CI= 1.45- 6.39 and OR= 3.05, 95% CI= 1.32 - 7.03, respectively）. However, placenta HBsAg positive was not associated with HBV DNA positive in newborns （X2 =0.09, P〉0.05）. Conclusion The risk of neonatal HBV serological mark