乙肝孕产妇血清HBV-DNA与乳汁HBV-DNA相关性的比较

目的探讨乙型病毒性肝炎(乙肝)孕产妇血清HBV-DNA与乳汁HBV-DNA的相关性,以期指导乙肝产妇的喂养方式。方法选取2008年12月至2009年12月收治的70例血清HBV抗原阳性孕产妇(乙肝组)及20例健康产妇(对照组)为研究对象,采用酶联免疫吸附试验(ELISA)检测血清及乳汁中免疫血清学标志物;采用荧光定量PCR法(FQ-PCR)检测血清及乳汁中HBV-DNA含量情况,并对所检测的指标进行相关性分析。结果采用ELISA检测到乙肝组产妇大三阳18例,小三阳27例,HBsAg、HBcAb均为阳性的有35例,乳汁HBV-DNA在各组中的检出的阳性率、病毒载量均小于血清HBV-DNA,但两者无显著性差异(P>0.05)。乳汁HBV-DNA的含量随血清HBV-DNA含量的升高而增大(P<0.05)。结论乙肝孕产妇要根据血清及乳汁中的HBV-DNA情况选择喂养方式,均为阴性才能进行哺乳。

Study on correlation of hepatitis B maternal serum HBV-DNA with HBV-DNA in milk

Objective To evaluate the correlation of viral hepatitis B maternal serum HBV-DNA with milk HBV-DNA in order to guide the feeding mode of mother with hepatitis B.Methods Seventy patients with positive maternal serum HBV antigen in this hospital during December 2008 to December 2009 were selected as trial group and 20 healthy lying-in women as control group.Milk,serum and immune serological markers were examined with enzyme-linked immunosorbent assay（ELISA）.HBV-DNA in serum and milk was determined by fluorescent quantitative polymerase chain reaction（FQ-PCR） assay.The situation of HBV-DNA in milk and serum and indexes detection was undergone with correlation analysis.Results Maternal HBsAg,HBeAg and HBcAb were positive in 18 cases,HBsAg,HBeAb and HBcAb were positive in 27 cases,HBsAg and HBcAb were positive in 35 cases.The positive rate of HBV-DNA and viral load in milk in all groups were less than those of serum,but the difference was not statistically significant（P 〉 0.05）.The level of HBV-DNA in milk was elevated following the increase of serum level of HBV-DNA,P 〈 0.05.Conclusion The choice of feeding mode should be selected according to milk and serum levels of HBV DNA,and breast feeding can be taking only at the time when HBV-DNA in milk and serum of mother turned to negative level.