- 期刊
The Significance of HBsAg, HBeAg and ANTI-HBc IgM IN Maternal-Infant Transmission of Hepatitis B Virus Infection
垂直感染中新生兒血乙型肝炎表面抗原、e抗原、IgM乙型肝炎核心抗體的臨床意義
摘要
在乙型肝炎表面抗原及e抗原陽性母親所生的新生兒中，有些在剛出生時的血中即呈現乙型肝炎表面抗原或e抗原陽性，其所代表的意義目前並不清楚。因此各選擇8對母子配對血清、利用放射綫免疫檢查方法，測定乙型肝炎表面抗原和e抗原值，並選擇6對母子配對血清，利用硫酸銨鹽沈澱法，測定其中的游離型e抗原及IgG結合型e抗原值，結果發現新生兒臍帶血中乙型肝炎表面抗原及e抗原值均小於母親血清值，且在母親血中含有較高的遊離型e抗原及IgG結合型e抗原，新生兒臍帶血中所含有的大部份都是IgG結合型e抗原，遊離型e抗原的量極微或甚至沒有，而利用酵素免疫檢查法測定20對母子配對血清的乙型肝炎核心抗體及IgM乙型肝炎核心抗體，其中有10對新生兒血清爲乙型肝炎表面抗原陽性。結果顯示所有母親及新生兒血中乙型肝炎核心抗體皆爲陽性，而所有母親及新生兒血中IgM乙型肝炎核心抗體告爲陰性，另外對9個新生兒臍帶血測定DNA polymerase活性，有6個顯示DNA polymerase陽性，但活性都很低，所有這些新生兒血中的轉銨酶都正常。由此可知，微量的乙型肝炎表面抗原及e抗原，甚至乙型肝炎病毒本身，可能是在週産期進入新生兒血中，因此母子垂直感染將可以乙型肝炎疫苗及乙型肝炎免疫球蛋白預防。
關鍵字
無資料並列摘要
In order to clarify the significance of the simultaneous Presence of hepatitis B surface antigen (HBsAg) and hepatitis B e antigen (HBeAg) in femoral blood of babies born to HBeAg positive mothers at birth, we used radioimmunoassay or enzyme-immunoassay to detect the HBsAg, HBeAg, antibody to hepatitis B core antigen (anti-HBc), and IgM class anti-NBc of maternal-infant paired sera sampled at birth. Free and IgG-bound form HBeAg were separated in maternal-infant paired sera both positive for HBeAg. We also analyzed the hepatitis B DNA polymerase of the cord sera at birth. We found that the titers of HBsAg in infants cord sera were much lower than those in the corresponding maternal sera (p＜0.05). The titers of HBeAg in infants' cord sera were also lower than than their mothers' sera (p＜0.05). The titers of free form and IgG -bound form HBeAg were quite different in infants and their mothers. Most HBeAg in infants were IgG-bound. Absence of IgM class anti-HBc in both mothers and infants was observed in 20 pairs of maternal-infant sera. DNA polymerase were found to be Positive in 6 of 9 cord sera, but were in low activity. None of the infants had elevation of serum transaminase activities at birth. These results indicate that HBsAg, HBeAg and even the virus particles themselves might pass through the placenta during the perinatal period, but they only infected the babies and have not yet infested them. Thus, if given at this stage, the Prevention of perinatal HBV infection by hepatitis B immune globulin and hepatitis B vaccine will be successful.