国际生殖健康/计划生育杂志

国际生殖健康/计划生育 ›› 2010, Vol. 29 ›› Issue (5): 369-371.

• 论著 • 上一篇    下一篇

妊娠相关蛋白A 及乙型肝炎病毒感染与稽留流产的关系

王明真,郁晓慧,槐中美,严群   

  1. 518081 深圳市盐田区妇幼保健院（王明真，郁晓 慧）；深圳市盐田区人民医院（槐中美）；深圳市盐田区盐港医院（严群）
  • 收稿日期:1900-01-01 修回日期:1900-01-01 出版日期:2010-09-15 发布日期:2010-09-15

Relationship Between Pregnancy-associated Plasma Protein A and Hepatitis B Virus Infection and Missed Abortion

WANG Ming-zhen, YU Xiao-hui，HUAI Zhong-mei，YAN Qun.   

  1. Shenzhen Yantian District Maternity and Child Healthcare Hospital，Shenzhen 518081, China （WANG Ming-zhen, YU Xiao-hui）； Shenzhen Yantian People’s Hospital，Shenzhen 518081, China (HUAI Zhong-mei); Shenzhen Yantian Yangang Hospital, Shenzhen 518083, China(YAN Qun)
  • Received:1900-01-01 Revised:1900-01-01 Published:2010-09-15 Online:2010-09-15

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摘要： 目的：探讨妊娠相关蛋白A(PAPP鄄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鄄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鄄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鄄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HBV
DNA 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鄄A 水平降低可预测有稽留流产的
可能；妊娠妇女血清中HBV鄄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。

关键词: 流产, 稽留, 妊娠蛋白质类, 肝炎, 乙型, 肝炎表面抗原, 乙型, DNA

Abstract: Objectives：To explore the impacts of PAPP鄄A (Pregnancy鄄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鄄A was detected by double antibody Sandwich enzyme鄄linked
immunosorbent technology (Sandwich ELISA); The HBV鄄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鄄A
and HBV鄄DNA load was analyzed. Results: The levels of PAPP鄄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鄄DNA positive, the serum DNA load and the DNA load in the tissue of
villus and decidua being higher than 1.0伊102 of the experimental group was higher than that of the control
group （P＜0.01, P＜0.05). HBV鄄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鄄A level in early trimester of
pregnancy can predict the probability of missed abortion. The higher serum HBV鄄DNA load of the pregnancy
women was one of the factors that caused intrauterine embryo HBV鄄infection in early pregnancy and the missed
abortion.

Key words: Abortion, missed, Pregnancy proteins, Hepatitis B, Hepatitis B surface antigens, DNA