乙型肝炎孕妇HBV血清标志物与HBV DNA载量及ALT的相关性分析
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摘要
目的分析乙型肝炎(乙肝)孕妇HBV血清标志物、HBV DNA载量及ALT检测结果,为HBV感染孕妇的诊治提供参考。方法回顾性分析2016年11月—2017年11月在我区孕检的120例乙肝孕妇的临床资料,应用酶联免疫吸附法检测血清五项HBV标志物,同时采用荧光实时定量PCR技术检测HBV DNA水平,酶速率法检测ALT,并对检测结果进行统计分析。结果 120例孕妇血清中,感染模式Ⅰ(大三阳)HBsAg(+)、HBeAg(+)、HBcAb(+)58例,占48.33%;HBV DNA(+)49例,占84.48%,其中HBV DNA> 10~6 IU/ml 42例,占72.41%;ALT增高39例,异常率为67.24%。感染模式Ⅱ(小三阳)HBsAg(+)、HBeAb(+)、HBcAb(+)45例,占37.50%;HBV DNA(+)27例,占60.00%,其中HBV DNA> 10~6 IU/ml 15例,占33.33%;ALT增高20例,异常率为44.44%。感染模式Ⅰ孕妇HBV DNA阳性率、HBV DNA> 10~6 IU/ml率和ALT异常率最高,感染模式Ⅱ孕妇次之。结论 HBV血清标志物与HBV DNA高载量和ALT水平密切相关,三者相结合能为孕妇的临床诊断、围产期干预措施以及疗效观察提供参考依据。
Objective To analyze the detection results of HBV serum markers, HBV DNA load and ALT levels in pregnant women with hepatitis B, and provide evidence for the diagnosis and treatment of HBV infected pregnant women. Methods One hundred and twenty pregnant women with hepatitis B who received a pregnancy test in our district from November 2016 to November 2017 were selected for a retrospective analysis of their clinical information. Five HBV serum markers were detected by enzymelinked immunosorbent assay. HBV DNA levels were detected by fluorescence real-time quantitative PCR and ALT was detected by enzyme rate assay. All detection results were statistically analyzed. Results In the serum of 120 pregnant women, infection pattern Ⅰ,that is HBsAg(+), HBeAg(+), HBcAb(+), was found in 58 cases, accounting for 48.33%; 49 cases were HBV DNA(+), accounting for 84.48%,of which HBV DNA > 106 IU/ml in 42 cases, accounting for 72.41%; ALT increased in 39 cases, and the abnormal rate was 67.24%.Infection pattern Ⅱ, that is HBsAg(+), HBeAb(+), HBcAb(+), was found in 45 cases, accounting for 37.50%; 27 cases were HBV DNA(+), accounting for 60.00%, of which HBV DNA > 106 IU/ml in 15 cases, accounting for 33.33%; ALT increased in 20 cases, and the abnormal rate was 44.44%; The positive rate of HBV DNA, the rate of HBV DNA > 106 IU/ml and the abnormal increase rate of ALT were the highest in pregnant women with infection pattern Ⅰ, followed by in those with infection pattern Ⅱ. Conclusions HBV serum markers are closely related to high HBV DNA load and ALT levels. The combination of these 3 indexes can provide a reference for perinatal interventions of pregnant women.
Objective To analyze the detection results of HBV serum markers, HBV DNA load and ALT levels in pregnant women with hepatitis B, and provide evidence for the diagnosis and treatment of HBV infected pregnant women. Methods One hundred and twenty pregnant women with hepatitis B who received a pregnancy test in our district from November 2016 to November 2017 were selected for a retrospective analysis of their clinical information. Five HBV serum markers were detected by enzymelinked immunosorbent assay. HBV DNA levels were detected by fluorescence real-time quantitative PCR and ALT was detected by enzyme rate assay. All detection results were statistically analyzed. Results In the serum of 120 pregnant women, infection pattern Ⅰ,that is HBsAg(+), HBeAg(+), HBcAb(+), was found in 58 cases, accounting for 48.33%; 49 cases were HBV DNA(+), accounting for 84.48%,of which HBV DNA > 106 IU/ml in 42 cases, accounting for 72.41%; ALT increased in 39 cases, and the abnormal rate was 67.24%.Infection pattern Ⅱ, that is HBsAg(+), HBeAb(+), HBcAb(+), was found in 45 cases, accounting for 37.50%; 27 cases were HBV DNA(+), accounting for 60.00%, of which HBV DNA > 106 IU/ml in 15 cases, accounting for 33.33%; ALT increased in 20 cases, and the abnormal rate was 44.44%; The positive rate of HBV DNA, the rate of HBV DNA > 106 IU/ml and the abnormal increase rate of ALT were the highest in pregnant women with infection pattern Ⅰ, followed by in those with infection pattern Ⅱ. Conclusions HBV serum markers are closely related to high HBV DNA load and ALT levels. The combination of these 3 indexes can provide a reference for perinatal interventions of pregnant women.
引文
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[11]吴著球,张学东. 58331例乙肝五项标志物定量检测不同模式分布分析[J].现代预防医学,2016,43(9):1691-1694.
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[13]王亚萍,刘惠媛,石裕明,等.乙型肝炎病毒感染孕妇561例的临床特征及母婴阻断情况[J].广东医学,2018,39(4):569-571.
[14] Wang AL, Qiao YP, Wang LH, et al. Integrated prevention of mother-to-child transmission for human immunodeficiency virus, syphilis and hepatitis B virus in China[J]. Bull World Health Organ, 2015, 93(1):52-56.
[15] Kang W, Li Q, Shen L, et al. Risk factors related to the failure of prevention of hepatitis B virus mother-to-child transmission in Yunnan, China[J]. Vaccine, 2017, 35(4):605-609.
[16]王智强,纪存委,高爽,等.广东省妇幼保健院门诊孕妇HBV感染状况分析[J].中国妇幼健康研究,2018,29(11):1491-1493.
[17]凌利芬,吴正林,李振华,等.乙肝病毒感染模式与病毒复制及丙氨酸氨基转移酶的关系[J].中国热带医学,2016,16(7):709-712.
[18]林晖,彭素媚,陈振杰. HBV-DNA和ALT、TBA水平与HBV感染模式的相关性研究[J].国际检验医学杂志,2014,35(14):1925-1927.
[2] Tariq S, Elford J, Chau C, et al. Loss to follow-up after pregnancy among sub-Saharan Africa-born women living with human immunodeficiency virus in England, Wales and Northern Ireland:results from a large national cohort[J]. Sex Transm Dis, 2016, 43(5):283-289.
[3] Liu J, Zhang S, Liu M, et al. Maternal pre-pregnancy infection with hepatitis B virus and the risk of preterm birth:a population-based cohort study[J]. Lancet Glob Health, 2017, 5(6):e624-e632.
[4] Tan J, Liu X, Mao X, et al. HbsAg positivity during pregnancy and adverse maternal outcomes:a retrospective cohort analysis[J]. J Viral Hepat, 2016, 23(10):812-819.
[5]董涛,刘丽,顾海英,等.秦皇岛地区健康体检人群24853例乙肝五项检测结果分析[J].标记免疫分析与免疫,2018,25(9):1339-1341.
[6] Durantel D, Zoulim F. New antiviral targets for innovative treatment concepts for hepatitis B virus and hepatitis delta virus[J]. J Hepatol, 2016, 64(Suppl 1):S117-S131.
[7]王晶晶,陈国凤,廖家杰,等.慢性乙型病毒性肝炎治疗现状和展望[J].传染病信息,2017,30(2):65-69.
[8]魏宏,庞秋梅.妊娠期抗病毒治疗阻断HBV母婴传播研究进展[J].传染病信息,2016,29(2):73-76.
[9] Sirilert S, Traisrisilp K, Sirivatanapa P, et al. Pregnancy outcomes among chronic carriers of hepatitis B virus[J]. Int J Gynaecol Obstet, 2014, 126(2):106-110.
[10]刘义庆,李丽,孙文萍,等.山东地区孕妇乙型肝炎感染和免疫状况分析[J].中国卫生检验杂志,2017,27(7):1029-1031.
[11]吴著球,张学东. 58331例乙肝五项标志物定量检测不同模式分布分析[J].现代预防医学,2016,43(9):1691-1694.
[12]唐海燕.孕期优生检查孕妇乙型肝炎五项结果报告分析[J].中国当代医药,2016,23(10):165-167.
[13]王亚萍,刘惠媛,石裕明,等.乙型肝炎病毒感染孕妇561例的临床特征及母婴阻断情况[J].广东医学,2018,39(4):569-571.
[14] Wang AL, Qiao YP, Wang LH, et al. Integrated prevention of mother-to-child transmission for human immunodeficiency virus, syphilis and hepatitis B virus in China[J]. Bull World Health Organ, 2015, 93(1):52-56.
[15] Kang W, Li Q, Shen L, et al. Risk factors related to the failure of prevention of hepatitis B virus mother-to-child transmission in Yunnan, China[J]. Vaccine, 2017, 35(4):605-609.
[16]王智强,纪存委,高爽,等.广东省妇幼保健院门诊孕妇HBV感染状况分析[J].中国妇幼健康研究,2018,29(11):1491-1493.
[17]凌利芬,吴正林,李振华,等.乙肝病毒感染模式与病毒复制及丙氨酸氨基转移酶的关系[J].中国热带医学,2016,16(7):709-712.
[18]林晖,彭素媚,陈振杰. HBV-DNA和ALT、TBA水平与HBV感染模式的相关性研究[J].国际检验医学杂志,2014,35(14):1925-1927.