摘要
目的:母亲乙肝病毒(HBV)感染在宫内即可造成其胎儿感染,但其机理尚不清楚.作者试图了解胎盘细胞中HBV的感染情况、宫内传播的危险因素和母胎传播的可能途径.方法:用ELISA,PCR和ABC免疫组织化学染色法检测血清和胎盘中的HBV感染标志.用病例对照方法分析危险因素.结累:101例HBsAg阳性母亲的婴儿宫内感染率为7.9%(8/101).母亲HBeAg阳性的婴儿宫内感染率明显高于母亲HBeAg阴性者(X^2=7.22,P<0.01).101例HBsAg阳性孕妇的胎盘中共检测出40例HBsAg和(或)HBeAg阳性者.其中蜕膜细胞(DC),滋养层细胞(TC),绒毛间质细胞(VSC)和绒毛毛细血管内皮细胞(VCEC)的阳性率分别为36.6%(37/101),28.7%(29/101),24.8%(25/101)和11.9%(12/101).阳性率由胎盘的母面至胎儿面有逐渐下降的趋势.由胎盘屏障的TC,VSC和VCEC感染而致的宫内传播的相对危险度比值比(OR)分别为9.13,11.68和43.50,OR值从胎盘的母面至胎儿面有逐渐上升的趋势.结论:HBV可感染胎盘组织.宫内感染的危险因素为母亲HBeAg阳性和胎盘屏障的感染.HBV经胎盘感染胎儿的途径可能是通过细胞转移方式实现的.
Maternal hepatitis B virus (HBV) infection can cause fetal infection in utero, but its mechanism is not clear. This paper tries to show the presence of HBV in pla-cental cells exposed to HBV during pregnancy, the risk factors of intrauterine infection and to trace the possible transmission route from mother to fetus. Methods: ELISA, PCR and ABC immunohistochemical staining with monoclonal anti-HBs and anti-HBc antibodies are used for detection of HBV infection markers in serum and placenta. Case control study is used for analysis of risk factors. Results: The intrauterine infection rate among the infants of 101 HBsAg-positive mothers was 7. 9%(8/101). The intrauterine infection rate among the infants of maternal HBeAg positive was significantly higher than that of maternal HBeAg negative (X2 = 7. 22, P< 0. 01). HBsAg and/or HBeAg were detected in 40 of 101 placentas of HBsAg-positive mothers. The positive rates in de-ctdual cell (DC), trophoblastic cell (TC), villous stromal cell (VSC) and villous capillary endothelial cell (VCEC) were 36.6% (37/101), 28.7% (29/101), 24.8% (25/101) and 11.9% (12/101), respectively. There is a gradually decrease of HBV infection from maternal side to fetal side of placenta. The ORs of HBV intrauterine infections due to infections of TC, VSC and VCEC of placenta barrier were 9. 13, 11. 68 and 43. 50, respectively. There is an increase trend of the ORs from maternal side to fetal side of placenta. Conclusion: HBV could infect placenta tissue. The risk factors of HBV intrauterine infection are maternal HBeAg positive and infection of placenta barrier. The transplacental transmission of HBV may be a cellular transfer.
出处
《第四军医大学学报》
1998年第2期125-128,共4页
Journal of the Fourth Military Medical University
基金
国家自然科学基金资助项目 No.39370611
