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目的探讨父亲血清HBV-DNA载量和孕母HBsAb对乙肝病毒(HBV)父婴垂直传播发生的影响,以期寻找阻断HBV父婴垂直传播的有效方法。方法在患者知情同意的前提下,以HBsAg及HBV-DNA为指标筛检父亲HBsAg阳性、孕母HBVM全阴或者仅HBsAb阳性及HBV-DNA均为阴性的121个家庭作为研究对象,依据其新生儿脐带血HBV-DNA检测结果作为分组标准,将HBV-DNA检测阳性23例作为病例组,阴性98例作为对照组,进行病例对照研究。结果 1新生儿脐带血HBV-DNA阳性率为19.0%(23/121);2父亲血清HBVDNA载量与新生儿脐带血HBV-DNA阳性率存在剂量反应关系(趋势χ2=60.108,P=0.000),受试者工作特征曲线(ROC曲线)分析表明:父亲血清HBV-DNA载量106拷贝/mL是预测HBV垂直传播发生较好的分界点;3孕母HBsAb阳性组与HBsAb阴性组其新生儿脐带血HBV-DNA阳性率差异有统计学意义(χ2=12.399,P=0.000),当父亲血清HBV-DNA载量≥?107拷贝/mL时,两组新生儿脐带血HBV-DNA阳性率差异无统计学意义(P>0.05)。结论父亲血清HBV-DNA阳性和孕母HBsAb阴性是HBV父婴垂直传播的危险因素,父亲血清HBV-DNA载量106拷贝/mL是较好的垂直传播发生的预测指标。
Objective To investigate the effect of serum HBV-DNA load and HBsAb on the vertical transmission of hepatitis B virus (HBV) in infants and young children in order to find out the effective way to block the vertical transmission of HBV between infants and infants. Methods Based on the informed consent of patients, 121 families with HBsAg-positive, HBVM-negative or HBsAb-positive and HBV-DNA negative were screened by HBsAg and HBV-DNA as the targets, Umbilical cord blood HBV-DNA test results as a grouping standard, HBV-DNA positive 23 cases as a case group, negative 98 cases as a control group, a case-control study. The positive rate of HBV-DNA in cord blood of neonates was 19.0% (23/121). (2) There was dose-response relationship between the serum HBV DNA load and the positive rate of HBV-DNA in umbilical cord blood of neonates (trend χ2 = 60.108, P = 0.000) The receiver operating characteristic curve (ROC curve) analysis showed that the father’s serum HBV-DNA load of 106 copies / mL is a good cut-off point to predict the vertical transmission of HBV; 3 neonatal HBsAb positive group and HBsAb negative group newborns The positive rate of HBV DNA in umbilical cord blood was statistically different (χ2 = 12.399, P = 0.000). When the serum HBV-DNA load of the father was ≥107 copies / mL, the positive rates of HBV-DNA in cord blood of the two groups were different No statistical significance (P> 0.05). Conclusions The positive serum HBV-DNA and negative HBsAb in pregnant women are the risk factors for the vertical transmission of HBV in infants. The serum HBV-DNA load of 106 copies / mL is the better predictor of vertical transmission.