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目的：拟从观察胎盘乙型肝炎病毒（ＨＢＶ）感染状态，探讨ＨＢＶ宫内传播发生的机制，以期为进一步预防ＨＢＶ宫内传播提供科学依据．方法：采用ＡＢＣ免疫组织化学染色检测ＨＢｓＡｇ阳性孕妇足月分娩胎盘ＨＢｓＡｇ和ＨＢｃＡｇ感染和分布状态．结果：在６２例足月分娩胎盘中，２１例检出了ＨＢｓＡｇ，８例检出ＨＢｃＡｇ．ＨＢｓＡｇ主要分布于蜕膜血管内皮细胞（１８例）、蜕膜细胞（２１例）、滋养层细胞（８例）、绒毛间质细胞（８例）和绒毛血管内皮细胞（５例）的胞浆和绒毛间隙（２１例）中．ＨＢｃＡｇ分布于蜕膜细胞（５例）、蜕膜血管内皮细胞（８例）和绒毛间质细胞（８例）的胞核内．结论：结果提示，ＨＢＶ可在胎盘组织中复制．ＨＢＶ经胎盘感染胎儿的主要途径可能是经血和（或）细胞传递方式实现的．即ＨＢＶ经蜕膜细胞和（或）绒毛间感染滋养层细胞，然后感染绒毛间质细胞，最终感染胎儿毛细血管内皮细胞
Objective: To observe the status of hepatitis B virus (HBV) infection in placenta and to explore the mechanism of intrauterine HBV transmission in order to provide a scientific basis for further prevention of HBV intrauterine transmission. Methods: ABC immunohistochemical staining was used to detect HBsAg and HBcAg infection and distribution in full term placenta of HBsAg positive pregnant women. Results: In 62 cases of term placenta delivery, HBsAg was detected in 21 cases and HBcAg was detected in 8 cases. HBsAg mainly distributed in the cytoplasm of decidual vascular endothelial cells (18 cases), decidual cells (21 cases), trophoblast cells (8 cases), villus mesenchymal cells (8 cases) and villus capillary endothelial cells (5 cases) And villus space (21 cases). HBcAg is distributed in the nucleus of decidual cells (5 cases), decidual vascular endothelial cells (8 cases) and villus stromal cells (8 cases). Conclusion: The results suggest that HBV can replicate in placental tissue. The main way HBV infects the fetus through the placenta may be menstrual blood and / or cell delivery. That is, HBV infects trophoblast cells between the decidual cells and / or the villus, and then infects the villus mesenchymal cells and finally infect the fetal capillary endothelial cells