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目的观察早期妊娠(孕40～90d)HBsAg阳性孕妇绒毛细胞乙型肝炎病毒(HBV)感染状况。方法采用酶联免疫吸附(ELISA)法,复查血清HBsAg阳性的25例早期妊娠妇女血清HBsAg、乙型肝炎e抗原(HBeAg),对其绒毛细胞用免疫组化链霉亲和素生物素过氧化物酶复合物(SABC)法和原位杂交法检测HBsAg、乙型肝炎核心抗原(HBcAg)和HBVDNA,并通过透射电镜观察绒毛细胞超微结构变化。结果25例HBsAg阳性孕妇中,HBV感染率为32%(8/25);蜕膜细胞、滋养细胞和绒毛间质细胞均出现HBsAg或HBcAg的阳性染色,出现HBsAg或HBcAg阳性蜕膜细胞、滋养细胞和绒毛间质细胞的标本百分率分别为28%(7/25)、32%(8/25)和16%(4/25);滋养细胞间桥粒连接完整,并在滋养细胞的粗面内质网内可见HBsAg蛋白丝样结构和HBV样结构。结论HBV可感染早期妊娠绒毛细胞;HBV直接穿透滋养细胞间桥粒连接的可能性不大。
Objective To observe the status of hepatitis B virus (HBV) infection in villi cells of HBsAg positive pregnant women in early pregnancy (40-90 days gestation). Methods Serum HBsAg and hepatitis B e antigen (HBeAg) were detected in 25 cases of HBsAg-positive early pregnancy women by enzyme-linked immunosorbent assay (ELISA), and their villus cells were stained with immunohistochemical streptavidin biotin HBsAg, HBcAg and HBVDNA were detected by enzyme-linked immunosorbent assay (SABC) and in situ hybridization. The ultrastructural changes of villus cells were observed by transmission electron microscopy. Results HBV infection rate was 32% (8/25) in 25 HBsAg positive pregnant women. Positive staining of HBsAg or HBcAg occurred in decidual cells, trophoblastic and villus mesenchymal cells, and HBsAg or HBcAg positive decidual cells appeared. The percentages of cells and villus stromal cells were 28% (7/25), 32% (8/25) and 16% (4/25), respectively. The desmosomes were well connected among trophoblast cells, Endoplasmic reticulum visible HBsAg protein filamentous structure and HBV-like structure. Conclusions HBV can infect villi cells in early pregnancy and HBV is unlikely to penetrate directly to the desmosomes in trophoblast cells.