产妇血清hbv dna含量对乳汁和新生儿血清hbv dna浓度的影响

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1、产妇血清HBVDNA含量对乳汁和新生儿血清HBVDNA浓度的影响作者：彭其才，许成芳，滕奔琦，侯红瑛【摘要】【目的】探讨乙型肝炎病毒携带产妇血清HBVDNA含量对乳汁和新生儿血清中HBVDNA含量的影响，以指导孕期处理和母乳喂养。【方法】选择乙型肝炎病毒携带产妇145例，采用荧光定量聚合酶链反应(FQ-PCR)技术对产妇血清、母乳和新生儿血清HBVDNA进行检测，并将产妇血清HBVDNA浓度分3级，分析产妇血清不同HBVDNA浓度级对乳汁及新生儿血清HBVDNA浓度的影响。【结果】血清HBVDNA<500copies/mL

2、的产妇74例，乳汁中检出HBVDNA阳性为零，新生儿血清HBVDNA阳性1例;血清HBVDNA浓度为500～1.0×106copies/mL产妇30例，乳汁中检出HBVDNA阳性为3例，新生儿血清HBVDNA阳性1例;血清HBVDNA浓度为≥1.0×106copies/mL产妇41例，乳汁中检出HBVDNA阳性为36例，阳性率为87.8%，新生儿血清HBVDNA阳性仅3例。【结论】产妇血清中HBVDNA≥1.0×106copies/mL时，乳汁中HBVDNA阳性率大幅度增加，而当产妇血清HBVDNA浓度小于1.0×106copi

3、es/mL，乳汁中HBVDNA检出率极低。产妇血清HBVDNA浓度对宫内感染影响不大。【关键词】HBVDNA;母婴传播;母乳喂养;荧光定量聚合酶链反应11　Abstract：【Objective】ToinvestigatetheeffectofmaternalHBV?鄄DNAconcentrationonthatofthebreastmilkofpostpartumandneonatuswithchronicHBVinfection.Soastoguidethetreatmentduringpregnancyandbreastf

4、eeding.【Methods】HBVDNAlevelsinserum，breastmilk，andneonatusserumweredetectedbyfluorescentquantitativepolymerasechainreactionin145postpartumwomenwithchronicHBVinfection.SerumHBVDNAwasgradedintothreelevels.TheeffectofdifferentgradeofmaternalserumHBVDNAonthebreastmilkand

5、neonatewasanalyzed.【Result】Seventy-fourcasesofmaternalserumHBVDNAquantitywere<500copies/mL，twooftheirbreastmilkHBV-DNAquantitywerepositive，oneneonatalserumHBVDNAquantitywaspositive.ThiritycasesofmaternalserumHBVDNAquantityrangedof500～1.0×106copies/mL，3casesshowedp

6、ositiveinbreastmilk，oneneonatalserumHBV-DNAquantityshowedpositive.Forty-onecasesofmaternalserumHBVDNAquantitywere>1.0×106copies/mL，theHBVDNApositiverateinbreastmilkreachedto87.8%(36cases)，onlythreecasesneonatusshowedpositiveinthereserumHBVDNAquantity.【Conclusions】

7、WhenmaternalserumHBVDNAquantitygoesbeyond>1.0×106copies/mL，11theHBVDNApositiverateinbreastmilkincreasessharply，whenserumHBVDNAquantitygoesbelow1.0×106copies/mL，theHBVDNApositiverateinbreastmilkisverylow.MaternalserumHBVDNAconcentrationhaslittleeffectonintrauterine

8、infection.　　我国是乙型肝炎病毒(HBV)感染高发区，陈志英等[1]调查报道产妇HBV感染度高达23.51%。如何降低HBV感染率，阻断HBV的母婴传播是研究重点。目前对于乙肝携带者妊娠后应用乙肝免疫球蛋白阻断HBV宫内感染的效果[2-4]和产后母乳喂