摘要
目的探讨乙型肝炎病毒(HBV)父母单一感染者辅助生殖助孕废弃胚胎中HBV DNA检测结果及影响因素,为HBV垂直传播的预防提供参考依据。方法选取2010年1月-2016年12月医院行辅助生殖助孕的200对夫妇废弃的胚胎200个,采用套式聚合酶链反应(PCR)对HBV DNA进行检测,以时间分辨荧光免疫分析技术检测父母感染者血清乙肝七项、荧光定量PCR法检测HBVDNA载量。结果 HBV单一感染父母HBsAg与HBcAb均为阳性,阳性率为100.00%,HBsAb、HBeAg、HBeAb、HBcAb-IgM、HBs1Ag阳性者分别有0例、59例、94例、7例、138例,阳性率为0.00%、29.50%、47.00%、3.50%、69.00%,HBVDNA阳性者200例,阳性率为100.00%,HBV DNA高载量者52例,阳性率为26.00%;200个胚胎,其中17个胚胎检测显示HBV DNA阳性,阳性率为8.50%;单因素分析,男方与女方年龄、受精方式、辅助生殖助孕次数、HBV感染者性别、HBs1Ag检测结果对胚胎HBV DNA检测结果无影响,HBeAg阳性、HBeAb阳性、HBcAb-IgM阳性、HBV DNA高载量阳性时胚胎HBV DNA阳性率分别为15.25%、13.83%、42.86%、19.23%,阴性时胚胎HBV DNA阳性率分别为5.67%、3.77%、7.25%、4.73%,比较差异有统计学意义(P<0.05),结果显示HBeAg、HBeAb、HBcAb-IgM、HBV DNA高载量检测结果对胚胎HBV DNA检测结果存在影响;多因素logistic回归分析结果显示HBV DNA高载量是胚胎HBV DNA检测结果的独立影响因素(P<0.05)。结论 HBV父母单一感染可引起胚胎HBV DNA阳性,感染者HBV DNA高载量是胚胎HBV感染的高风险因素,建议在受孕前应进行针对性治疗,以降低胚胎感染HBV风险。
OBJECTIVE To discuss and detection of HBV DNA of assisted reproduction in human abandon embryos and risk factors in patients with single parent infections of HBV,so as to provide references for the prevention of HBV vertical transmission.METHODS A total of 200 human abandon embryos from 200 couples with assisted reproduction from Jan.2010 to Dec.2016 were selected.HBV DNA in the embryos was detected by nest PCR,serum HBV seven in mother/father with HBV infection was analyzed by time-resolved fluorescence immunoassay technology,and serum HBV DNA was detected by real-time fluorescence quantitative PCR.RESULTS HBsAg and HBcAb in mother/father with HBV infection were positive,and the positive rate was 100.00%.Totally 0 case was positive of HBsAb（0.00%）,59 cases were positive of HBeAg（29.50%）,94 cases were positive of HBeAb（47.00%）,7 cases were positive of HBcAb-IgM（3.50%）,and 138 cases were positive of HBs1 Ag（69.00%）,respectively.A total of 200 cases were positive of HBV DNA,accounting for 100.00%.There were 52 cases with high load of HBV DNA,accounting for 26.00%.Totally 17 cases were positive of HBV DNA of human embryos,accounting for 8.50%.Univariate analysis showed that,mother and father＇s age,insemination method,auxiliary reproductive number of assisted reproduction,gender of the patient with HBV infection and HBs1 Ag test results had no effects on HBV DNA test results of human embryos.HBV DNA positive rates of human embryos were 15.25%,13.83%,42.86% and 19.23% with HBeAg positive,HBeAb positive,HBcAb-IgM positive and high load of HBV DNA positive,respectively,and were 5.67%,3.77%,7.25%and 4.73% when they were negative,and the differences were significant（P〈0.05）.The results showed that the detection results of HBeAg,HBeAb,HBcAb-IgM and high load of HBV DNA had influences on HBV DNA test results of human embryos.Multiariable logistic regression analysis showed that high load of HBV DNA was the independent risk factor for HBV DNA test results of human embryos（P〈0.05）.CONCLUSIONS
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2017年第21期4982-4985,共4页
Chinese Journal of Nosocomiology
