【摘要】 目的:探讨乙肝表面抗原(HBsAg)阳性父亲精液乙型肝炎病毒脱氧核糖核酸(HBV-DNA)载量对其新生儿发生HBV父婴垂直传播的影响,以期寻找阻断HBV父婴垂直传播的有效方法.方法:在知情同意的原则,以丈夫血清HBsAg阳性、孕母HBsAg及HBV-DNA均阴性的52个家庭作为研究对象,收集父母及其新生儿的相关资料及血液标本和父亲精液标本,检测血液乙肝病毒血清学标志物(HBVM)、HBV-DNA载量与精液HBV-DNA载量.依据其新生儿脐带血HBV-DNA检测结果作为分组标准,HBV-DNA检测为阳性11例为病例组,阴性41例为对照组,进行病例对照研究.结果:新生儿脐带血HBV-DNA阳性率为21.2%(11/52),52份精液HBV-DNA阳性率为26.9%(14/52);精液HBV-DNA阳性父亲其新生儿发生HBV父婴垂直传播的危险性高于精液HBV-DNA阴性者(P<0.01);精液与其血清的HBV-DNA载量存在正相关关系,精液HBV-DNA载量低于其血清载量;ROC曲线分析显示,精液HBV-DNA载量在预测HBV垂直传播发生风险的效果优于血清HBV-DNA载量.结论:父亲精液HBVDNA载量是HBV父婴垂直传播的危险因素;HBsAg阳性的男性在计划孕育前降低其血液及精液中HBV-DNA载量水平能降低HBV父婴垂直传播的风险.更多还原

【Abstract】 Aim: To explore the impact of the load levels of paternal semen HBV-DNA on vertical transmission of HBV from HBsAg-positive father to infant. Methods: 52 families of pregnant women with negative HBsAg and HBV-DNA and husbands with positive,serum HBsAg were selected. Clinical data and blood samples of the parents and their newborns、semen samples of the husbands were collected. Serum HBVM and the load levels of paternal blood and semen HBV-DNA were determined. In case-control study,based on the results of neonatal cord blood HBV-DNA detection,11 newborns with cord blood positive HBV-DNA were selected as subiects,and 41newborns with negative HBV-DNA as controls. Results:①The positive rate of neonatal cord blood HBV-DNA was found to be 21. 2%( 11/52),and that of semen HBV-DNA was 26. 9%( 14 /52). ②The incidence of vertical transmission of HBV in infants with paternal positive semen HBV-DNA was found significantly higher than that in infants with paternal negative semen HBV-DNA( P < 0. 01). ③There was a positive rank correlation between semen and serum of HBV-DNA load levels,while the load levels of semen HBV-DNA was lower than that of serum HBV-DNA load levels. ④The analysis of ROC curve showed that the prediction accuracy of semen HBV-DNA in the occurrence of vertical transmission were more accurate than that based on serum HBV-DNA load. Conclusion: Paternal positive semen HBV-DNA is one of the risk fators for vertical transmission of HBV; reducing HBV-DNA load levels in paternal blood and semen before pregnancy may be a way to block fatherfetal transmisson of HBV.更多还原