贵州省HBsAg筛查阳性孕妇乙型肝炎病毒DNA检测分析

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目的分析贵州省孕妇乙型肝炎病毒(HBV)DNA状况,为制定和调整HBV母婴阻断方案提供科学依据。方法采用分层随机抽样的方法抽取4个市州,在4个市州中随机抽取9个县级医院作为调查单位,对调查单位内2014-2015年住院分娩的孕妇开展HBV表面抗原(HBs Ag)筛查;对HBs Ag阳性的孕妇开展问卷调查并采集血标本,分离血清后采用PCR结合荧光探针的体外DNA扩增和检测技术定量检测血清标本中的HBV DNA含量。结果共筛查9个县级医院18 007名孕妇,经ELISA方法复测HBs Ag阳性534名,孕妇HBV DNA阳性率为55.99%。9个县孕妇HBV DNA阳性率33.33%~85.29%,差异有统计学意义(P<0.05)。城市、农村孕妇HBV DNA阳性率分别为56.99%和55.78%,城、乡差异无统计学意义(P>0.05)。≤20岁组孕妇HBV DNA阳性率为59.06%,21~30岁组为46.67%,差异有统计学意义(P<0.05)。HBs Ag、HBe Ag阳性孕妇HBV DNA阳性检出率分别为59.27%和90.61%,HBs Ag、HBe Ag阳性分别与HBs Ag、HBe Ag阴性(18.06%、33.02%)孕妇间HBV DNA阳性检出率差异有统计学意义(P<0.01)。HBs Ag、HBe Ag阳性孕妇分别与HBs Ag、HBe Ag阴性孕妇间HBV DNA平均载量差异有统计学意义(P<0.05)。结论定量检测孕妇HBV DNA能真实反映HBV的复制情况,可为制定预防和控制HBV母婴传播策略提供科学依据。 Objective To analyze the DNA status of hepatitis B virus (HBV) in pregnant women in Guizhou province and provide a scientific basis for the development and adjustment of HBV maternal and infant block programs. Methods Four cities and prefectures were selected by stratified random sampling method. Nine county-level hospitals were randomly selected from four cities and prefectures as investigation units. HBV-surface antigen (HBsAg ) Screening; HBsAg-positive pregnant women to carry out a questionnaire survey and blood samples were collected, the serum was detected by PCR and fluorescence probe in vitro DNA amplification and detection of quantitative detection of HBV DNA in serum samples. Results A total of 18 007 pregnant women in 9 county hospitals were screened. 534 HBsAg positive patients were tested by ELISA. The positive rate of HBV DNA in pregnant women was 55.99%. The positive rate of HBV DNA in pregnant women in 9 counties was 33.33% ~ 85.29%, the difference was statistically significant (P <0.05). The positive rates of HBV DNA in urban and rural pregnant women were 56.99% and 55.78%, respectively. There was no significant difference between urban and rural (P> 0.05). The positive rate of HBV DNA in pregnant women ≤20 years old was 59.06%, while that in 21 ~ 30 years old was 46.67%, the difference was statistically significant (P <0.05). The positive rates of HBV DNA in pregnant women with positive HBs Ag and HBeAg were 59.27% ​​and 90.61% respectively, and the positive rates of HBV DNA in pregnant women with negative HBsAg and HBe Ag (18.06%, 33.02%) were respectively The difference was statistically significant (P <0.01). The average load of HBV DNA between HBsAg and HBeAg-positive pregnant women and HBsAg and HBeAg-negative pregnant women was statistically significant (P <0.05). Conclusion Quantitative detection of HBV DNA in pregnant women can truly reflect the replication of HBV and provide a scientific basis for the development of strategies to prevent and control HBV transmission.
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