嬰兒HBV血清學(xué)標(biāo)志物HBsAb、HBeAb、HBcAb陽性模式影響因素分析
發(fā)布時間：2019-01-27 10:07
【摘要】：目的:本研究旨在探討嬰兒HBV血清標(biāo)志物HBs Ab、HBe Ab、HBc Ab陽性影響因素,隨訪了解HBs Ab、HBe Ab、HBc Ab變化情況,為臨床工作提供參考,同時讓臨床醫(yī)生進一步了解OBI,使隱匿性HBV感染者得到早期干預(yù)。方法:收集2014.1.1-2016.11.30于我院行HBV血清學(xué)標(biāo)志物檢測(HBVM)HBs Ab、HBe Ab、HBc Ab陽性且年齡小于6月的5968例嬰兒及78例HBV DNA檢測結(jié)果,從收集的5968例嬰兒中篩選出母親為HBV感染的嬰兒,并收集其乙肝疫苗接種、HBIG、母孕期乙肝病毒攜帶狀態(tài)、分娩方式、喂養(yǎng)方式等資料。隨訪部分嬰兒HBV血清學(xué)標(biāo)志物檢測結(jié)果,并對所有資料進行回顧性分析。結(jié)果:1.5968例HBs Ab、HBe Ab、HBc Ab陽性嬰兒中,新生兒所占比例為69.1%(4121/5968),母親為HBV陽性者占13.4%(796/5968),HBV感染母親的嬰兒與非HBV感染母親的嬰兒HBs Ab、HBe Ab、HBc Ab測定值差異均具有統(tǒng)計學(xué)差異(P=0.0000.05)。2.721例HBV感染母親的嬰兒HBs Ab、HBe Ab、HBc Ab陽性影響因素多重回歸分析結(jié)果顯示:母親乙肝病毒感染攜帶狀態(tài)對嬰兒HBs Ab測定值存在顯著性負(fù)相關(guān),以母親乙肝大三陽者為參照,母親HBs Ag(+)者與HBs Ab的回歸系數(shù)β為-0.249(P=0.0010.05),母親乙肝小三陽者與HBs Ab的回歸系數(shù)β為-0.406(P0.001),說明與母親乙肝大三陽者比,母親乙肝小三陽、HBs Ag(+)者的HBs Ab測定值更低。其他變量對HBs Ab的測定值影響均沒有統(tǒng)計學(xué)意義。嬰兒年齡對HBe Ab測定值存在顯著性正相關(guān)(β=0.195,P0.001),年齡越大,HBe Ab測定值越高。另外,母親乙肝病毒感染攜帶狀態(tài)對HBe Ab測定值存在顯著性負(fù)相關(guān),以母親乙肝大三陽者為參照,母親HBs Ag(+)者與HBe Ab的回歸系數(shù)β為-0.377(P0.001),母親乙肝小三陽者與HBe Ab的回歸系數(shù)β為-0.448(P0.001),說明與母親乙肝大三陽者比,母親乙肝小三陽、HBs Ag(+)者的HBe Ab測定值更低。其他變量對HBe Ab的影響均沒有統(tǒng)計學(xué)意義。嬰兒年齡對HBc Ab測定值存在顯著性負(fù)相關(guān)(β=-0.377,P0.001),嬰兒年齡越大,HBc Ab測定值越低。母親年齡與HBc Ab測定值存在顯著性正相關(guān)(β=0.098,P=0.0110.05),母親年齡越大,HBc Ab測定值越高。另外,以母親乙肝大三陽者為參照,母親HBs Ag(+)者與HBc Ab存在顯著負(fù)相關(guān)(β=-0.204,P=0.0040.05),母親乙肝小三陽對HBc Ab的影響沒有統(tǒng)計學(xué)意義,說明與母親乙肝大三陽者相比,母親HBs Ag(+)者的HBc Ab測定值更低。其他變量對HBc Ab的影響均沒有統(tǒng)計學(xué)意義。3.78例HBs Ab、HBe Ab、HBc Ab陽性嬰兒行HBV DNA檢測,有2例母親為乙肝病毒感染嬰兒HBV DNA檢測陽性(2/78),其中1例嬰兒隨訪至1歲4月時HBV DNA檢測已為陰性。4.52例隨訪嬰兒,男性31例,女性21例,平均隨訪年齡為2.4歲,所有隨訪者中,除1例HBc Ab仍為陽性外,其余隨訪者HBe Ab、HBc Ab均轉(zhuǎn)陰。按隨訪時間間隔不同分為4組,分別為6月組、6月-1年組、1-2年組、2年組,各隨訪組中均存在兒童隨訪后HBs Ab濃度較隨訪前降低,及HBs Ab無應(yīng)答或低應(yīng)答表現(xiàn),在隨訪兒童中,母親是否為HBV感染對其免疫應(yīng)答失敗率無統(tǒng)計學(xué)意義(P=0.510.05)。結(jié)論:1.所有受檢嬰兒中,以新生兒出現(xiàn)HBs Ab、HBe Ab、HBc Ab陽性最為常見,HBV感染母親所生嬰兒血清HBe Ab、HBc Ab濃度較非HBV感染母親所生嬰兒高,HBs Ab濃度較非HBV感染母親所生嬰兒低。2.母孕期乙肝病毒感染攜帶狀態(tài)可影響嬰兒HBs Ab、HBe Ab、HBc Ab濃度,且隨著年齡的增長,HBe Ab、HBc Ab濃度逐漸下降。3.部分HBV感染母親所生嬰兒母嬰阻斷后雖然HBs Ag陰性且HBs Ab陽性,伴或不伴HBc Ab陽性,但血清HBV DNA檢測陽性,提示免疫阻斷后仍可能存在隱匿性乙肝病毒感染,建議對HBV感染母親所生嬰兒免疫阻斷后除完善HBV血清學(xué)檢查外,若有條件者,還應(yīng)行HBV DNA檢查,對HBs Ag陰性但HBV DNA陽性嬰兒,應(yīng)定期隨訪.4.隨訪過程中,大部分嬰兒HBe Ab、HBc Ab有轉(zhuǎn)陰趨勢,在不同隨訪年齡階段均有50%以上的兒童出現(xiàn)隨訪后HBs Ab濃度較隨訪前降低,且伴有免疫應(yīng)答失敗或低應(yīng)答。
[Abstract]:Objective: The purpose of this study was to study the positive factors of HBsAg, HBe Ab and HBc Ab in the infants with HBV serum markers. Follow-up to understand the changes of HBs Ab, HBe Ab and HBc Ab and provide reference for clinical work. Methods: A total of 5968 infants with HBV infection and 78 cases of HBV DNA were collected from the collected 5968 infants, and the hepatitis B vaccine was collected and HBIG was collected from the collected 5968 infants. The status of the hepatitis B virus in the mother's pregnancy, the mode of delivery, the feeding mode and so on. The results of the detection of the serum markers of HBV in the infants were followed up, and all the data were analyzed retrospectively. Results: 1. 5968 of the positive infants with HBs Ab, HBe Ab and HBc Ab, the proportion of the newborn was 61.9% (4121/ 5968), the mother was 13. 4% (796/ 5968) of the HBV-positive, and the infant and non-HBV-infected mother of the HBV-infected mother and the non-HBV-infected mother were the anti-HBs Ab and the HBe Ab. The results of the multiple regression analysis of the positive influence factors of HBc Ab and HBc Ab in the infants with HBV infection showed that the status of HBV infection in the mother had a significant negative correlation with the measured value of the infant's HBs Ab. The regression coefficient of the mother's HBs Ag (+) and the HBs Ab was-0.249 (P = 0. 0010. 05), and the regression coefficient of the mother's B-3-positive and the HBs Ab was-0.406 (P0.001), indicating that the mother's B. The HBs antigen of the HBsAg (+) was lower than that of the HBsAg (+). The effect of other variables on the determination of HBs Ab was not statistically significant. There was a significant positive correlation between the age of the baby and the measured value of the HBe Ab (P = 0.195, P 0.001). The higher the age, the higher the value of the HBe Ab. In addition, there was a significant negative correlation between the status of HBV infection of mother and the value of HBe Ab, and the regression coefficient of the mother's HBs Ag (+) and HBe Ab was-0.377 (P0.01), and the regression coefficient of the mother's hepatitis B and the HBe Ab was-0.448 (P0.001). The results showed that the measured value of HBe Ab for HBsAg (+) was lower than that of the mother's hepatitis B. The effects of other variables on the HBe Ab were not statistically significant. There was a significant negative correlation between the infant age and the measured value of HBc Ab (P =-0.377, P 0.001), the higher the age of the baby, and the lower the value of HBc Ab. There was a significant positive correlation between the age of the mother and the measured value of HBc Ab (P = 0.098, P = 0.0110. 05), the higher the age of the mother, and the higher the measured value of HBc Ab. In addition, there was a significant negative correlation between the mother's HBs Ag (+) and the HBc Ab (P =-0.204, P = 0. 0040. 05), and the effect of the mother hepatitis B triyang on the HBc Ab was not statistically significant. The serum HBc Ab of the mother's HBs Ag (+) was lower. There was no significant difference in the effect of other variables on the HBc Ab. Of these, 1 case was followed up to the age of 1, and the detection of HBV DNA was negative. 4. 52 follow-up infants, 31 males and 21 females. The average follow-up age was 2. 4 years. All the follow-up patients, except 1 case of HBc Ab, were still positive, and all the remaining follow-up HBc Ab and HBc Ab were negative. The follow-up time interval was divided into 4 groups, 6 months, 6 months to 1 year group, 1 to 2 year group and 2 year group. In the follow-up group, the concentration of the HBs Ab was lower than that before the follow-up, and the HBs Ab was no response or low response, and in the follow-up children, The failure rate of the immune response of the mother was not statistically significant for HBV infection (P = 0.510. 05). Conclusion: 1. The HBc Ab and HBc Ab were the most common among all the infants tested, and the serum HBe Ab and HBc Ab in the mother of HBV infection were higher than that of the non-HBV-infected mothers, and the concentration of the HBs Ab was lower than that of the non-HBV-infected mothers. The status of HBV infection in mother pregnant women could affect the concentration of HBc Ab, HBc Ab and HBc Ab, and with the increase of age, the concentration of HBe Ab and HBc Ab decreased gradually. The serum HBV DNA was positive with or without the positive of the HBc Ab, but the HBV DNA in the serum was positive. In addition to improving the serological test of HBV, it is suggested that, in addition to improving the serological test of HBV, if there are conditions, HBV DNA should be checked, and the positive infants with HBsAg negative but HBV DNA should be followed up regularly. 4. During the follow-up, the majority of the infants with the HBe Ab and HBc Ab had a tendency to change the negative. In the different follow-up age, more than 50% of the children had a decrease in the concentration of the HBs Ab after follow-up and accompanied by a failure of an immune response or a low response.
【學(xué)位授予單位】：重慶醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R725.1
本文編號：2416162
[Abstract]:Objective: The purpose of this study was to study the positive factors of HBsAg, HBe Ab and HBc Ab in the infants with HBV serum markers. Follow-up to understand the changes of HBs Ab, HBe Ab and HBc Ab and provide reference for clinical work. Methods: A total of 5968 infants with HBV infection and 78 cases of HBV DNA were collected from the collected 5968 infants, and the hepatitis B vaccine was collected and HBIG was collected from the collected 5968 infants. The status of the hepatitis B virus in the mother's pregnancy, the mode of delivery, the feeding mode and so on. The results of the detection of the serum markers of HBV in the infants were followed up, and all the data were analyzed retrospectively. Results: 1. 5968 of the positive infants with HBs Ab, HBe Ab and HBc Ab, the proportion of the newborn was 61.9% (4121/ 5968), the mother was 13. 4% (796/ 5968) of the HBV-positive, and the infant and non-HBV-infected mother of the HBV-infected mother and the non-HBV-infected mother were the anti-HBs Ab and the HBe Ab. The results of the multiple regression analysis of the positive influence factors of HBc Ab and HBc Ab in the infants with HBV infection showed that the status of HBV infection in the mother had a significant negative correlation with the measured value of the infant's HBs Ab. The regression coefficient of the mother's HBs Ag (+) and the HBs Ab was-0.249 (P = 0. 0010. 05), and the regression coefficient of the mother's B-3-positive and the HBs Ab was-0.406 (P0.001), indicating that the mother's B. The HBs antigen of the HBsAg (+) was lower than that of the HBsAg (+). The effect of other variables on the determination of HBs Ab was not statistically significant. There was a significant positive correlation between the age of the baby and the measured value of the HBe Ab (P = 0.195, P 0.001). The higher the age, the higher the value of the HBe Ab. In addition, there was a significant negative correlation between the status of HBV infection of mother and the value of HBe Ab, and the regression coefficient of the mother's HBs Ag (+) and HBe Ab was-0.377 (P0.01), and the regression coefficient of the mother's hepatitis B and the HBe Ab was-0.448 (P0.001). The results showed that the measured value of HBe Ab for HBsAg (+) was lower than that of the mother's hepatitis B. The effects of other variables on the HBe Ab were not statistically significant. There was a significant negative correlation between the infant age and the measured value of HBc Ab (P =-0.377, P 0.001), the higher the age of the baby, and the lower the value of HBc Ab. There was a significant positive correlation between the age of the mother and the measured value of HBc Ab (P = 0.098, P = 0.0110. 05), the higher the age of the mother, and the higher the measured value of HBc Ab. In addition, there was a significant negative correlation between the mother's HBs Ag (+) and the HBc Ab (P =-0.204, P = 0. 0040. 05), and the effect of the mother hepatitis B triyang on the HBc Ab was not statistically significant. The serum HBc Ab of the mother's HBs Ag (+) was lower. There was no significant difference in the effect of other variables on the HBc Ab. Of these, 1 case was followed up to the age of 1, and the detection of HBV DNA was negative. 4. 52 follow-up infants, 31 males and 21 females. The average follow-up age was 2. 4 years. All the follow-up patients, except 1 case of HBc Ab, were still positive, and all the remaining follow-up HBc Ab and HBc Ab were negative. The follow-up time interval was divided into 4 groups, 6 months, 6 months to 1 year group, 1 to 2 year group and 2 year group. In the follow-up group, the concentration of the HBs Ab was lower than that before the follow-up, and the HBs Ab was no response or low response, and in the follow-up children, The failure rate of the immune response of the mother was not statistically significant for HBV infection (P = 0.510. 05). Conclusion: 1. The HBc Ab and HBc Ab were the most common among all the infants tested, and the serum HBe Ab and HBc Ab in the mother of HBV infection were higher than that of the non-HBV-infected mothers, and the concentration of the HBs Ab was lower than that of the non-HBV-infected mothers. The status of HBV infection in mother pregnant women could affect the concentration of HBc Ab, HBc Ab and HBc Ab, and with the increase of age, the concentration of HBe Ab and HBc Ab decreased gradually. The serum HBV DNA was positive with or without the positive of the HBc Ab, but the HBV DNA in the serum was positive. In addition to improving the serological test of HBV, it is suggested that, in addition to improving the serological test of HBV, if there are conditions, HBV DNA should be checked, and the positive infants with HBsAg negative but HBV DNA should be followed up regularly. 4. During the follow-up, the majority of the infants with the HBe Ab and HBc Ab had a tendency to change the negative. In the different follow-up age, more than 50% of the children had a decrease in the concentration of the HBs Ab after follow-up and accompanied by a failure of an immune response or a low response.
【學(xué)位授予單位】：重慶醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R725.1
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