目的探讨HBsAg阳性孕妇外周血乙型肝炎病毒(HBV)DNA含量及细胞转运与新生儿HBV感染的关系。方法用荧光定量PCR方法定量检测HBsAg阳性孕妇血清HBV DNA; 用等位基因特异性PCR及半巢式PCR技术扩增HBsAg阳性孕妇新生儿外周血中母亲DNA,通过检测谷胱甘肽-S-转移酶(GSTM1)、血管紧张素转换酶(ACE)等位基因确定母-胎细胞转运; 用巢式PCR检测新生儿血清、外周血单个核细胞(PBMC)中HBV DNA。结果随着孕妇血清HBV DNA含量的增加,新生儿HBV DNA阳性的危险性呈现增高趋势(总χ2=13.16,P〈0.05,趋势χ2=12.42,P〈0.05),而孕妇血清HBV DNA含量与新生儿PBMC HBV DNA阳性无关(总χ2=2.41,P〉0.05,趋势χ2=0.35,P〉0.05); 孕妇血清HBV DNA含量与母-胎细胞转运无关(总χ2=4.14,P〉0.05,趋势χ2=0.001,P〉0.05); 母-胎细胞转运与新生儿外周血PBMC HBV DNA阳性有关(χ2=10.26,P(0.05),而与新生儿外周血HBV DNA阳性无关(χ2=0.49,P〉0.05)。结论HBsAg阳性孕妇血清HBV DNA含量、母-胎细胞转运与新生儿HBV感染有关,分别是新生儿血清、PBMC HBV感染的重要危险因素。
Objective To study the relationship between hepatitis B virus(HBV),DNA content in pregnant mother,mother-fetus cell transportion and HBV infection in newborn.Methods HBV DNA contents in blood of pregnant women were detected by real-time fluorescence quantitative PCR.DNA in mother and in fetus was amplified by allele-specific PCR and heminested PCR.The cell transportion of mother-fetus was determined by detecting GSTM1 and ACE.HBV DNA in newborns' peripheral blood serum and peripheral blood monouclear cells (PBMC) was determined by nested PCR.Results The risk of HBV DNA positive in the newborn increased with the increment of serum HBV DNA of the mother(total χ2=13.16,P0.05,tendency χ2=12.42,P0.05).But serum HBV DNA content of the mother was not retaled to peripheral blood mononuclear cell(PBMC) HBV DNA positive in the newborn(total χ2=2.41,P0.05,tendency χ2=0.35,P0.05) and to the mother-fetus cell transportion (total χ2=4.14,P0.05,tendency χ2=0.001,P0.05).Mother-fetus cell transportion was related to PBMC HBV DNA positive in the newborn(χ2=10.26,P0.05),but not related to HBV DNA positive in the newborn(χ2=0.49,P0.05).Conclusion There are associations between HBV DNA content in HBsAg positive mother,mother-fetus cell transportion and HBV infection in newborn.The HBsAg positive mother's HBV DNA content is the risk factor of HBV infection of the newborn and mother-fetus cell transportion is the risk factor of PBMC HBV infection of the newborn.