【摘要】 目的研究乙型肝炎病毒(HBV)携带产妇前C区和核心启动子(CP)区热点变异情况及与宫内感染的关系。方法采用HBV核酸扩增荧光定量检测试剂盒抽提99对无症状乙型肝炎病毒表面抗原(HBsAg)阳性携带临产孕妇及其新生儿血清HBV DNA,EIA法检测血清HBsAg、HBeAg,半巢式PCR法扩增产妇HBV前C区、CP区核苷酸片断,ABI3730型DNA自动荧光测序仪对PCR产物直接测序。结果 82例(单阳性52例,双阳性30例)孕妇HBV前C区和CP区核苷酸片断扩增测序成功。无症状HBV携带单阳性孕妇中1896G→A变异的检出率为21.2%(11/52,仅测到1例双阳性孕妇存在1896G→A变异);1899G→A变异仅发生在1例单阳性孕妇,且与1896G→A变异连锁出现。1762A→T/1764G→A变异总是连锁出现,且仅发生于单阳性孕妇,单阳性孕妇中双变异的检出率为17.3%(9/52)。1896G→A变异和无该点变异孕妇所生新生儿宫内感染率分别为25.0%(3/12)和37.1%(26/70)(P>0.05);1762A→T/1764G→A变异和无该点变异的单阳性孕妇所生新生儿宫内感染率分别为22.2%(2/9)和37.2%(16/43)(P>0.05)。结论 HBV前C区和CP区1896G→A及1762A→T/1764G→A热点变异在无症状HBV携带单阳性孕妇中有较高的检出率,而在HBsAg、HBeAg双阳性孕妇中的检出率较低。HBV前C区和C启动子区热点变异对宫内感染率无显著影响。更多还原

【Abstract】 Objective To investigate the hot point mutations in the precore and core promoter(CP) regions of HBV DNA in pregnant woman and explore the possible relationship between hot point mutations and intrauterine infection.Methods The HBV DNA of 99 pregnant women with positive asymptomatic HBsAg and their newborns in serum was extracted with HBV PCR fluorogence diagnostic kit.The HBsAg and HBeAg in serum were detected by ELA method.The precore and CP regions of HBV DNA were amplified by semi-nested PCR,and then were subjected to direct sequencing.Results The precore and CP regions of HBV DNA were successfully amplified and sequenced in 82 pregnant women(52 women with negative HBeAg and 30 women with positive HBeAg).HBV 1896G→A mutation was found in 12 pregnant women,but only one of them was positive HBeAg.The detection rate of 1896G→A mutation in pregnant women with negative HBeAg was 21.2%(11/52).1899G→A mutation was only found in a pregnant woman with negative HBeAg,and was linked with 1896G→A mutation.1762A→T mutation was always linked with 1764G→A mutation.1762A→T/1764G→A double mutation was found in pregnant women with negative HBeAg,and the detection rate of it was 17.3%(9/52).There was no significant difference of the rate of HBV intrauterine infection in newborns between 1896G→A mutation and without 1896G→A mutation(25.0% vs.37.1%)(P>0.05).The rate of HBV intrauterine infection in newborns with 1762A→T/1764G→A double mutation was not different from that without 1762A→T/1764G→A double mutation(22.2% vs.37.2%)(P>0.05).Conclusion The detection rates of 1896G→A and 1762A→T/1764G→A mutations in the precore and CP regions of HBV DNA are relatively high in pregnant women with positive asymptomatic HBsAg,but are rare in pregnant women with positive HBsAg and HBeAg.The hot point mutations in the precore and CP regions of HBV DNA in pregnant women may not affect the detection rate of HBV intrauterine infection.更多还原