乙肝孕妇病毒载量与类风湿因子及胎盘生长因子相关性研究

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1、授予单位代码10089学号或申请号15395中国图书分类号R714.251HebeiMedicalUniversity硕士学位论文学术学位乙肝孕妇病毒载量与类风湿因子及胎盘生长因子相关性研究研究生：武长芬导师：陈铎教授专业：妇产科学二级学院：河北医科大学附属第二医院2018年3月0目录中文摘要································································································1英文摘要·······························

2、·····································································3研究论文乙肝孕妇病毒载量与类风湿因子及胎盘生长因子相关性研究前言·········································································································6对象与方法··································································

3、·······················7结果····································································································11附表·································································································13讨论················································

4、·················································15结论···································································································18参考文献·························································································18综述乙肝孕妇体内免疫学与细胞因子的关系研究进展·······

5、·············23致谢········································································································32个人简历··························································································331乙肝孕妇病毒载量与类风湿因子及胎盘生长因子相关性研究摘要背景：我国是乙型肝炎的高流行地区，乙型肝炎病毒携带率为10.0

6、%-20.0%，且40.0%-50.0%通过母婴传播，我国每年约200万新生儿由于母婴传播出生时携带乙肝病毒。目前，临床上对于乙型肝炎治疗主要以干扰素（IFN）或核苷酸类药物治疗为主，能干扰病毒DNA的合成。但是，乙肝本身属于是一个炎症性的病理过程，文献报道，类风湿因子（RF）作为一种由于机体受到细菌、病毒等病原体的感染引起的炎症因子,在乙型肝炎患者病情发展中发挥了很大的作用。另外胎盘生长因子（placentagrowthfactor，PLGF）的产生可能与肝内受刺激的血管内皮细胞或炎症细胞关系密切，加之孕妇处于特殊的生理时期,了解乙肝孕妇病毒载量与类

7、风湿因子及胎盘生长因子的相关性，对制定相应的个体化母婴阻断治疗方案具有重要的意义。目的：探讨乙肝孕妇病毒载量与类风湿因子及胎盘生长因子的相关性，为孕妇母婴阻断从免疫水平提供一定的理论依据。方法：选取2016年4月-2016年12月医院收治妊娠合并乙肝孕妇90例，根据HBV-DNA载量分为3组。A组HBV-DNA载量≥10E+06mIU/mL即高病毒载量组。B组HBV-DNA载量介于10E+02mIU/mL至10E+06mIU/mL间即中病毒载量组。C组HBV-DNA载量≤10E+02mIU/mL即低病毒载量组，每组30例。取同期入院正常妊娠分娩孕妇30

8、例，设为对照组（D组）。A组分为自孕期28周口服核苷酸药物正规母婴阻断治疗（A1组）及孕期未采