【作者】 陶蓓；

【导师】 张松英；

【作者基本信息】 浙江大学 ， 妇产科学， 2006， 硕士

【摘要】 一、研究背景和目的 乙型病毒性肝炎(简称乙肝)是法定乙类传染病,具有传染性强、传播途径复杂、流行面广泛、发病率高。部分乙肝患者可演变为慢性,并可发展为肝硬化和原发性肝癌,成为一个严重的公共卫生问题。全球60亿人口中,约有1/2人口生活在乙肝病毒(HBV)高流行区,约20亿人证明有HBV感染,3～4亿人为HBV临床感染,这些慢性感染人群其中25～40%最终将死于肝硬化和肝癌。世界卫生组织报告,全球每年因乙肝死亡约75万例,为第七大死亡原因。我国属于HBV高和中流行区,且主要感染年龄为围产期和幼儿期。这两个时期的感染来源往往为宫内感染以及出生后母乳喂养及密切生活接触,仅极少部分为来自父系的遗传传递。 过去认为宫内传播率较低,近来国内外学者通过对乙肝患者引产的胎儿胎盘病理分析提示宫内感染率大于过去的估计。急性乙肝更多还原

【Abstract】 Background and ObjectiveHepatitis B(HB), the legal B contagious disease, has the character of complicated spreading way. Parts of hepatitis B patients will develop chronic carriers, and even to cirrhosis and original liver cancer. It is a serious public health problem. About 1/2 population of 600 million on the earth live in high spreading area of hepatitis B virus (HBV), about 200 million people were proved HBV infected, 30~40 million of among them were clinical infected, 25%~40% of which will be dead for cirrhosis or liver cancer. World Health Organization (WHO) reported that 750 thousand death cases owe to HBV. Our country belongs to the high and middle spreading area, where most of cases happened during the perinatal period and childhood. Transmission patterns includeintrauterine infection, mother milk feeding, living engage closely and little father heredity.In the past, it was believed that there was a low rate of intrauterine infection. But recent standpoint was said that the situation were more serious. For this reason, to control intrauterine infection will prevent the rage of HB effectually. In order to achieve the aim, we investigate the serum of HBV carrier mothers and later of their infants.Materials and Methods1. MaterialsHBV carrier mothers and later their infants. 57 mothers and their 57 infants were followed for 9 — 18 months. Their serum was investigated.2. MethodsHBVM was measured by ECL methods. HBV-DNA was detected byQ-PCR.3. Statistical analysisAll the data were analyzed using SPSS 10.0 Statistical analysis software. Student’s x2’test was used to analysis differences between infected group and control group.Results1. 8 of 57 newborn infants were observed infected, the rate of infection was 14.04%.2. Comparing with peripheral venous blood sample, the sensitivity and positive predictive value of HBV detected in cords was 100.00%, 80.00%respectively.3. 9-—-18 months later, 14 of the infants became HBV chronic carriers.4. The fetal infectious rate in mothers with HBeAg or HBV-DNA positive was 86.67%, 100.00%, respectively which was significantly higher than that in mothers with HBeAg or HBV-DNA negative. PO.01.Conclusions1. HBeAg or HBV-DNA positive in mothers is one of the risk factors of intrauterine infection.2. HBeAg or HBV-DNA negative mothers are also infectious.3. Detection of HBV-DNA in cord blood is a sensitive index for diagnosing fetal infection , however detection of peripheral venous blood is with the significance of making correct diagnosis.更多还原