论文部分内容阅读
为了解乙型肝炎病毒 ( HBV)宫内传播的危险因素与机制 ,笔者进行了病例对照研究与胎盘组织的免疫组化。收集陕西省妇幼保健院 2 4 2例 HBs Ag阳性的孕妇及其新生儿作为研究对象。结果显示 ,母亲 HBe Ag阳性 ( OR=32 .63)和先兆早产史 ( OR=2 2 .80 )是主要的危险因素。在 32例足月孕妇的免疫组化 HBs Ag阳性的胎盘组织中 ,HBs Ag阳性率在脱膜细胞层为 10 0 % ,滋养层细胞为 59.38% ,绒毛间质细胞为 65.50 % ,绒毛毛细血管内皮细胞为 39.38% ,表明 HBV感染从母面到胎儿血管呈逐渐下降趋势 ( P<0 .0 1)。而且绒毛毛细血管 HBs Ag阳性与婴儿宫内感染有关( OR=2 0 .86,P<0 .0 1)。根据上述结果 ,我们提出假设 :HBV宫内传播可能有两条途径 :经先兆早产等引起的胎盘血管渗漏的“血源传播”和 HBV经胎盘各层细胞“转移”至胎儿血循环的“细胞转移传播”。
To understand the risk factors and mechanisms of hepatitis B virus (HBV) intrauterine transmission, the author conducted a case-control study and immunohistochemistry of placental tissue. A total of 224 HBsAg-positive pregnant women and their newborns from Shaanxi MCH hospital were collected as research subjects. The results showed that maternal HBe Ag positive (OR = 32.63) and threatened preterm birth (OR = 2.80) were the major risk factors. In 32 cases of full-term pregnant women with immunohistochemical HBsAg-positive placental tissue, HBsAg positive rate of 10% in the stripping cell layer, trophoblast cells was 59.38%, villus mesenchymal cells was 65.50%, villus capillary Endothelial cells were 39.38%, indicating that HBV infection from the mother to the fetal blood vessels showed a downward trend (P <0.01). Moreover, the positive of villi capillaries HBs Ag was associated with intrauterine infection (OR = 20.86, P <0.01). Based on the above results, we hypothesized that intrauterine HBV transmission may have two pathways: “blood-borne transmission” of placental vascular leakage caused by threatened premature delivery and “cell transfer” of HBV through the layers of the placenta into the bloodstream of the fetus Transfer of communication. "