标题：HBsAg阳性产妇乙肝感染状况及新生儿血清中HBsAg和HBsAb水平分析

      作者：卢小娟 1，罗秋平 2，汪红艳 3，汪俊 4，高婧 1，孟伟伟 1    1.深圳市宝安区石岩人民医院检验科，广东 深圳 518108；2.深圳市龙华区人民医院检验科，广东 深圳 518109；3.深圳市宝安区石岩人民医院公共关系科，广东 深圳 518108；4.深圳市宝安区石岩人民医院输血科，广东 深圳 518108

      卷次： 2020年31卷7期

      【摘要】 目的 探究乙肝表面抗原(HBsAg)阳性产妇的乙肝感染状况及新生儿血清中HBsAg、乙肝表面抗体(HBsAb)水平变化，为患者的临床诊断提供指导。方法 选择2017年10月至2018年12月在深圳市宝安区石岩人民医院产检的456例HBsAg阳性产妇作为研究对象。分析HBsAg阳性产妇的乙肝感染情况及母婴乙型肝炎病毒(HBV)传播率，比较不同血清学模式、不同HBV DNA载量产妇新生儿的乙肝病毒血清学标志物水平。结果 所有HBsAg阳性产妇均为HBV阳性；456例产妇分娩的新生儿中有89例为HBsAg阳性，母婴垂直传播率为19.52%；不同血清学模式产妇新生儿脐带血的HBV DNA载量水平以及HBV DNA阳性率、HBsAg阳性率和HBsAb阳性率比较差异均有统计学意义(P<0.05)；HBV NDA载量越高的孕产妇，其新生儿脐带血的HBV DNA载量水平以及HBVDNA阳性率、HBsAg阳性率越高，HBsAb阳性率越低，差异均有统计学意义(P<0.05)。结论 HBsAg阳性产妇的HBV母婴传播率极高，新生儿的血清HBsAg、HBsAb水平存在异常表达，HBV-DNA载量水平以及血清学模式是影响HBV母婴传播的重要因素。
      【关键词】 乙型肝炎；乙型肝炎病毒载量；乙肝表面抗原；乙肝表面抗体；母婴传播
      【中图分类号】 R714.251 【文献标识码】 A 【文章编号】 1003—6350（2020）07—0879—03

Analysis of hepatitis B infection in HBsAg positive puerperas and the levels of serum HBsAg and HBsAb inneonates.
LU Xiao-juan 1, LUO Qiu-ping 2, WANG Hong-yan 3, WANG Jun 4, GAO Jing 1, MENG Wei-wei 1. 1. Departmentof Clinical Laboratory, Shiyan People's Hospital, Baoan District, Shenzhen 518108, Guangdong, CHINA; 2. Department ofClinical Laboratory, Shenzhen Longhua District People's Hospital, Shenzhen 518109, Guangdong, CHINA; 3. Department ofPublic Relations, Shiyan People's Hospital, Baoan District, Shenzhen 518108, Guangdong, CHINA; 4. Department of BloodTransfusion, Shiyan People's Hospital, Baoan District, Shenzhen 518108, Guangdong, CHINA
【Abstract】 Objective To study the hepatitis B infection in Hepatitis B Surface Antigen (HBsAg) positive puer-peras and the levels of serum HBsAg and Hepatitis B Surface Antibody (HBsAb) in neonates. Methods A total of 456HBsAg-positive parturients who underwent maternity examination in Shiyan People's Hospital, Baoan District, Shen-zhen from October 2017 to December 2018 were selected as the subjects of study. The infection of hepatitis B in HBsAgpositive parturients and the transmission rate of Hepatitis B virus (HBV) between mother and infant were observed andanalyzed. And the serological markers of hepatitis B virus in pregnant women and neonates with different serological pat-terns and different HBV DNA loads were compared. Results All the 456 HBsAg positive mothers were HBV positive,and 89 newborns were HBsAg positive, which showed that the vertical transmission rate between mother and infant was19.52%. There was significant difference in HBV DNA load, HBV DNA positive rate, HBsAg positive rate, and HBsAbpositive rate of umbilical cord blood between different serological models (P<0.05). Higher HBV DNA load was corre-lated with higher HBV DNA load level in cord blood and higher positive rate of HBV DNA and HBsAg, and also associ-ated with lower positive rate of HBsAb, with statistically significant difference (P<0.05). Conclusion The moth-er-to-child transmission rate of HBV in HBsAg positive parturients is high, and the serum levels of HBsAg and HBsAbin newborns are abnormally expressed. The level of HBV-DNA load and serological pattern are important factors affect-ing the mother-to-child transmission of HBV.
      【Key words】 Hepatitis B infection; HBV viral load; Hepatitis B surface antigen; Hepatitis B surface antibody;Mother-to-child transmission