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妊娠中晚期乙型肝炎表面抗原阳性妇女胎盘感染的研究

马建新 白钢钻 冯丽萍 王素萍 徐德忠

  【摘要】 目的 探讨乙型肝炎表面抗原(HBsAg)阳性妇女妊娠中晚期胎盘各层细胞的乙型肝炎病毒感染状况。方法 收集太原市传染病医院妇产科HBsAg阳性产妇胎盘167例(其中足月分娩胎盘158例,中期引产胎盘9例),用免疫组织化学ABC染色法检测胎盘蜕膜细胞、滋养层细胞、绒毛间质细胞和绒毛毛细血管内皮细胞HBsAg和乙型肝炎核心抗原(HBcAg)。结果 (1)足月分娩胎盘蜕膜细胞、滋养层细胞、绒毛间质细胞和绒毛毛细血管内皮细胞均感染乙型肝炎病毒,以胞浆分布为主,局灶性分布多见。从蜕膜细胞、滋养层细胞、胎盘间质细胞至绒毛毛细血管内皮细胞,乙型肝炎病毒感染率呈下降趋势,总感染率分别为66.46%(105/158)、58.23%(92/158)、27.22%(43/158)和12.66%(20/158)。(2)中期引产胎盘有1例发生乙型肝炎病毒感染(1/9)。结论 乙型肝炎病毒可感染足月分娩胎盘各型细胞,从母面向胎儿面,胎盘乙型肝炎病毒感染指标逐渐下降,提示胎盘乙型肝炎病毒感染多发生在妊娠晚期;妊娠中期胎盘乙型肝炎病毒感染的机会较低。
  【关键词】 肝炎病毒,乙型; 疾病传播,垂直; 胎盘; 免疫组织化学

Study on Hepatitis B Virus Infection Status in Plancetas of Hepatitis B Surface Antigen Positive Pregnant Women During Middle and Late Period of Pregnancy

MA Jianxin, BAI Gangzuan, FENG Liping, et al
(Department of Obstetrics and Gynecology, Tai Yuan Infectious Disease Hospital, Tai Yuan, 030012, China)

  【Abstract】 Objective To investigate Hepatitis B Virus (HBV) infection status in placentas of Hepatitis B Surface Antigen (HBsAg) positive pregnant women during middle and late period of pregnancy. Methods One hundred and sixty-seven placentas from HBsAg positive pregnant women were collected, including 158 term placentas and 9 aborted second-trimester placentas. HBsAg and hepatitis B core antibody (HBcAg) in placental cytotypes were detected by immunohistochemistry. Results Of the 158 term placentas, HBV infection rates in decidual cells (DC), trophoblastic cells (TC), villous mesenchymal cells (VMC) and villous capillary endothelial cells (VCEC) were 66.46% (105/158), 58.23% (92/158), 27.22% (43/158) and 12.66% (20/158), respectively. The HBV infection rates gradually decreased from maternal side to fetal side of placentas. Both HBsAg and HBcAg were mainly located in the cytoplasm of infected cells. The positive cells were mostly in focal distribution. One out of 9 aborted second-trimester placentas was infected. Conclusions HBV infection was found in different cells

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