【摘要】 目的:探讨妊娠相关蛋白A(PAPP-A)及乙型肝炎病毒(HBV)感染对稽留流产的影响。方法:收集稽留流产患者(观察组)及正常妊娠行人工流产者(对照组)的血清、胚胎组织,采用双抗体夹心酶联免疫吸附技术(Sandwich ELISA)检测血清PAPP-A水平;采用定量PCR法检测绒毛组织及蜕膜组织中HBV DNA水平,分析PAPP-A水平与HBV DNA载量的关系。结果:观察组(无论是否感染乙型肝炎病毒)PAPP-A水平均低于对照组。观察组HBsAg阳性妊娠妇女中DNA阳性者占74.36%,对照组HBsAg阳性妊娠妇女中DNA阳性者占15%,观察组高于对照组(P<0.01)。HBV DNA阳性的观察组和对照组血清HBVD NA载量差异有统计学意义(P<0.01),观察组高于对照组。HBV DNA阳性的观察组和对照组胚胎组织中HBV DNA载量值>1.0×102者所占比例差别有统计学意义(P<0.05),观察组多于对照组。胚胎组织中与外周血中HBV DNA的量呈正相关(P<0.05)。结论:妊娠早期血清PAPP-A水平降低可预测有稽留流产的可能;妊娠妇女血清中HBV-DNA载量高是妊娠早期胚胎宫内感染乙型肝炎病毒及稽留流产的预测指标之一。更多还原

【Abstract】 Objectives:To explore the impacts of PAPP-A (Pregnancy-associated plasma protein A) and HBV (Hepatitis B virus) on missed abortion.Methods:The serum and tissues of villus and decidua of the missed abortion patients (experimental group) and the normal pregnancies that have artificial abortion(control group) were collected.The serum level of PAPP-A was detected by double antibody Sandwich enzyme-linked immunosorbent technology (Sandwich ELISA);The HBV-DNA level in tissues of villus and decidua was tested by using the quantitative polymerase chain reaction (PCR),and the relationship between the level of PAPP-A and HBV-DNA load was analyzed.Results:The levels of PAPP-A of the experimental group (whether or not infected with Hepatitis B) were all lower than that of the control group.For the subjects with HBsAg positive,the DNA seropositive rate of the experimental group (74.36%) was higher than that of the control group (15%,P<0.01).For the subjects with HBV-DNA positive,the serum DNA load and the DNA load in the tissue of villus and decidua being higher than 1.0×102 of the experimental group was higher than that of the control group (P<0.01,P<0.05).HBV-DNA load in villus tissue showed positive correlation to the virus load in the peripheral blood (P <0.05).Conclusions:The decreasing of serum PAPP-A level in early trimester of pregnancy can predict the probability of missed abortion.The higher serum HBV-DNA load of the pregnancy women was one of the factors that caused intrauterine embryo HBV-infection in early pregnancy and the missed abortion.更多还原