乙型肝炎病毒宫内感染的机制。
Mechanism of intrauterine infection of hepatitis B virus.
作者信息
Zhang Shu-Lin, Yue Ya-Fei, Bai Gui-Qin, Shi Lei, Jiang Hui
机构信息
Department of Infectious Disease, First Hospital of Xi'an Jiaotong University, Xi'an 710061, Shaanxi Province, China.
出版信息
World J Gastroenterol. 2004 Feb 1;10(3):437-8. doi: 10.3748/wjg.v10.i3.437.
AIM
To explore the possible mechanism of intrauterine infection of hepatitis B virus (HBV).
METHODS
HBV DNA was detected in vaginal secretion and amniotic fluid from 59 HBsAg-positive mothers and in venous blood of their newborns by PCR. HBsAg and HBcAg in placenta were determined by ABC immunohistochemistry.
RESULTS
The rate of HBV intrauterine infection was 40.1% (24/59). HBV DNA was detected in 47.5% of amniotic fluid samples and 52.5% of vaginal secretion samples respectively. HBsAg and HBcAg were detected in placentas from HBsAg-positive mothers. The concentration of the two antigens decreased from the mother's side to the fetus's side, in the following order: maternal decidual cells > trophoblastic cells > villous mesenchymal cells > villous capillary endothelial cells. However, in 4 placentas the distribution was in the reverse order. HBsAg and HBcAg were detected in amniotic epithelial cells from 32 mothers.
CONCLUSION
The main route of HBV transmission from mother to fetus is transplacental, from the mother side of placenta to the fetus side. However, HBV intrauterine infection may take place through other routes.
目的
探讨乙型肝炎病毒（HBV）宫内感染的可能机制。
方法
采用聚合酶链反应（PCR）检测59例HBsAg阳性母亲的阴道分泌物、羊水及其新生儿静脉血中的HBV DNA。采用ABC免疫组织化学法检测胎盘组织中的HBsAg和HBcAg。
结果
HBV宫内感染率为40.1%（24/59）。羊水样本和阴道分泌物样本中HBV DNA的检出率分别为47.5%和52.5%。在HBsAg阳性母亲的胎盘中检测到HBsAg和HBcAg。两种抗原的浓度从母体侧到胎儿侧呈递减趋势，依次为：母体蜕膜细胞＞滋养层细胞＞绒毛间充质细胞＞绒毛毛细血管内皮细胞。然而，有4例胎盘的分布顺序相反。在32例母亲的羊膜上皮细胞中检测到HBsAg和HBcAg。
结论
HBV从母亲传给胎儿的主要途径是经胎盘，从胎盘的母体侧到胎儿侧。然而，HBV宫内感染可能通过其他途径发生。
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