目的 研究慢性hbv感染产妇乳汁的传染性及可能的预测指标.方法 慢性hbv感染产妇64例,采用荧光定量pcr技术检测其外周血血清和乳汁中的hbv dna水平,以其≥1.0×103拷贝/ml判为阳性,并进行相关性分析.结果 64例慢性hbv感染产妇血清和乳汁中hbv dna的阳性检出率分别为78.1%和62.5%.其中,乳汁hbv dna水平在1.05×103～3.87×1044拷贝/ml.分析结果显示,当血清hbv dna水平在105～107拷贝/ml时,乳汁hbv dna的阳性率高达94.9%;而当血清hbv dna水平在103～104拷贝/ml时,乳汁hbv dna的阳性率则仅为18.2%.结论 慢性hbv感染产妇的乳汁hbv dna阳性检出率随着血清中hbv dna拷贝数的增加而升高;血清hbv dna水平≥105拷贝/ml的产妇,应避免母乳喂养.
abstract：
objective to investigate the prediction of maternal hbv transmission by breast milk of postpartum women with chronic hbv infection.methods hbv dna levels in serum and breast milk were detected by fluorescent quantitative polymerase chain reaction in 64 postpartum women with chronic hbv infection.hbv dna≥1.0×103copies/ml was defined as positive,and correlation analysis was conducted.results hbv dna positive rate was 78.1%and 62.5%in serum and breast milk respectively,with a hbv dna range of 1.05×103～3.87 ×104copies/ml in breast milk.when hbv dna in serum was 1.0×105～1.0×107copies/ml,the hbv dna positive rate in breast milk reached to 94.9%;however,when hbv dna in serum was 1.0×103～1.0×104copies/ml,the positive rate in breast milk was only 18.2%.conclusion the hbv dna positive rate of breast milk in postpartum women with chronic hbv infection is correlated with the hbv dna levels in serum;and breast-feeding should be avoided for postpartum women with hbv dna≥1.0×105copies/ml in the serum.so serum hbv dna detection is necessary in antenatal care for women with chronic hbv infection.
