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目的:选择灵敏度高、重复性较好的乳汁HBV-DNA定量标本提取方法应用于乙肝携带产妇的乳汁检测。方法:选择14例乙肝“大三阳”产妇乳汁,每份分为乳汁原标本,乳汁离心后中层,乳汁离心后下层沉淀混合液3组,分别提取HBV-DNA并检测含量,用秩和检验分析结果的差异;用乳汁离心后中层对316例乙肝产妇检测HBV-DNA含量。结果:乳汁离心后中层清液灵敏度高于乳汁原样本,乳汁离心后中层清液重复性高于下层沉淀混合液。在316例乙肝产妇中,血清HBsAg+、HBeAg+、HBcAb+组,其乳汁HBV-DNA阳性率为77.60%;血清HBsAg+,HBeAb+,HBcAb+组其乳汁HBV-DNA阳性率为0.73%,血清HBsAg+,HBeAg+组乳汁HBV-DNA阳性率为80.00%,血清HBsAg+和HBcAb+组乳汁HBV-DNA阳性率为5.17%,其余组别乳汁HBV-DNA阳性率皆为0。结论:乙肝携带者产妇的乳汁可用于评估母乳喂养安全性。在乙肝产妇乳汁中,以其血清HBsAg+、HBeAg+、HBcAb+者和血清HBsAg+、HBeAg+者母乳喂养小儿被传染乙肝病毒的风险较大。
OBJECTIVE: To select the method of quantitative HBV-DNA extraction from breast milk with high sensitivity and good reproducibility, and to apply it to the breast milk detection of pregnant women carrying HBV. Methods: 14 cases of hepatitis B “big three positive ” maternal milk, each divided into raw milk samples, milk centrifuged after the middle, milk centrifuged after the lower sediment mixture of three groups were extracted and detected HBV-DNA content And test the difference between the analysis of results; with milk after centrifugation of 316 cases of hepatitis B maternal HBV-DNA testing. Results: After centrifugation, the sensitivity of middle serum was higher than that of the original latex. The supernatant of latex after centrifugation was higher than that of the lower sediment. The positive rate of HBV-DNA in breast milk was 77.60% in serum of HBsAg +, HBeAg + and HBcAb + group in 316 cases. The positive rates of serum HBV-DNA in serum of HBsAg +, HBeAb + and HBcAb + group were 0.73%, serum of HBsAg + and HBeAg + group The positive rate of HBV-DNA was 80.00%. The positive rate of HBV-DNA in serum of HBsAg + and HBcAb + groups was 5.17%. The positive rates of other HBV-DNA were all 0. Conclusion: The maternal milk from hepatitis B carriers can be used to assess the safety of breastfeeding. In the maternal milk of hepatitis B, the risk of being infected with hepatitis B virus is high in children who are breast-fed with their serum HBsAg +, HBeAg +, HBcAb + and serum HBsAg +, HBeAg +.