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目的:探讨HBV前S1蛋白与胎儿感染的相关性,为筛查HBsAg阳性孕产妇中可能感染胎儿的高危人群提供参考依据。方法:采用酶联免疫吸附试验(ELISA)双抗体夹心方法、分级定量PCR检测、酶联免疫吸附试验,检测256例HBV携带孕妇及其分娩的256例新生儿静脉血前S1蛋白、HBV DNA及HBV标志物。结果:①256例新生儿中发生HBV感染81例,感染率为31.6%。②前S1蛋白阳性孕产妇所分娩的85例新生儿中,感染率为88.2%(75/85),显著高于前S1蛋白阴性者的3.5%(6/171)(P<0.01)。③在感染的81例新生儿中,有79例其母前S1蛋白阳性(97.5%)(79/81),81例其母HBVDNA阳性,两者差异无统计学意义(P>0.01)。结论:①孕妇单纯HBsAg阳性,其婴儿感染率相对较低,如合并有前S1蛋白阳性或HBV DNA阳性,则胎盘传播率显著上升;②前S1蛋白检测可以代替血HBV DNA检测作为判断胎儿宫内感染的重要依据,可作为筛查HBsAg阳性孕产妇中易发生垂直传播人群的方法。
Objective: To investigate the correlation between HBV pre-S1 protein and fetal infection and to provide a reference for screening high-risk groups of HBsAg-positive pregnant women who may be infected with fetus. Methods: 256 cases of HBV-carrying pregnant women and 256 newborn infants with venous pre-S1 protein, HBV DNA and HBV DNA were detected by enzyme linked immunosorbent assay (ELISA) double antibody sandwich method, grading quantitative PCR and enzyme linked immunosorbent assay HBV marker. Results: 81 cases of HBV infection occurred in 251 neonates with infection rate of 31.6%. ② Among 85 newborns delivered by pre-S1 protein-positive pregnant women, the infection rate was 88.2% (75/85), significantly higher than 3.5% (6/171) (P <0.01) of pre-S1 protein-negative women. Among the 81 infants infected, 79 had positive pre-S1 protein (79.5%) (79/81), and 81 had positive HBVDNA. There was no significant difference between the two groups (P> 0.01). Conclusions: ①While pregnant women are only HBsAg positive, the infection rate of their babies is relatively low. If there is a positive or positive HBV DNA before pregnancy, the placental transmission rate increases significantly. ② The detection of pre-S1 protein can replace the detection of blood HBV DNA as a marker of fetus An important basis for infection, can be used as a screening method for HBsAg-positive pregnant women prone to vertical transmission of the crowd.