乙型肝炎患者胎盘组织中GSK-3β表达与HBV母婴传播的关系

Relationship discussion between GSK-3β expression in placenta tissue and HBV maternal-neonatal transmission in hepatitis B patients

摘要:

目的 探讨乙型肝炎（以下简称乙肝）患者胎盘组织中糖原合成激酶3β（GSK-3β）表达与乙型肝炎病毒（HBV）母婴传播的关系。方法 选取2014年4月—2018年1月中国医科大学附属盛京医院定期产检及分娩的乙肝孕妇189例（研究组），另选取同期正常孕妇106例（对照组）。两组均于产前抽取肘静脉血，并于胎盘娩出后30?min内留取胎盘组织，采用实时荧光定量聚合酶链反应（qRT-PCR）对HBV-DNA进行检测，采用免疫组织化学法检测两组孕妇胎盘组织中GSK-3β表达情况，另于研究组新生儿出生后24?h内采集股静脉血，采用酶联免疫吸附试验检测乙肝5项（乙肝两对半），根据检测结果将新生儿分为感染组与未感染组。比较感染组与未感染组胎盘组织GSK-3β表达情况，并分析GSK-3β表达与HBV感染孕妇出现新生儿HBV感染的关系。结果 研究组胎盘组织中GSK-3β阳性表达率及GSK-3β吸光度值与对照组比较，差异有统计学意义（P?<0.05），研究组高于对照组；研究组孕妇外周血HBV-DNA滴度>1×102 copy/ml的胎盘组织GSK-3β阳性表达率及GSK-3β吸光度值高于HBV-DNA滴度≤1×102 copy/ml孕妇（P?<0.05）；研究组189例新生儿中有19例发生HBV感染，新生儿HBV感染率为10.05%（19/189）；感染组胎盘组织中GSK-3β阳性表达率及GSK-3β吸光度值与未感染组比较，差异有统计学意义（P?<0.05），感染组高于未感染组；经Logistic多元逐步回归模型分析，乙肝孕妇血清HBV-DNA载量>1×102?copy/ml、血清HBeAg阳性及胎盘组织GSK-3β阳性表达是新生儿HBV感染的危险因素（OlR=1.956、1.978和1.931，均P?<0.05）。结论 乙肝患者胎盘组织中GSK-3β阳性表达率增加，且随着孕妇外周血HBV-DNA滴度的升高而增加，GSK-3β高表达可增加HBV母婴传播发生风险。

Abstract:

Objective To investigate the relationship between the expression of glycogen synthetase kinase 3β (GSK-3β) in placenta tissue and hepatitis B virus (HBV) maternal-neonatal transmission in hepatitis B patients. Methods Totally 189 pregnant women with hepatitis B who underwent regular obstetric examination and delivery were selected from April 2014 to January 2018 in our hospital (study group), and 106 normal pregnant women during the same period were selected (control group). The elbow vein blood was extracted before delivery from the pregnant women, and placental tissue were retained within 30 min after delivery, and the HBV-DNA was detected by fluorescence quantitative real-time polymerase chain reaction (qRT-PCR), and GSK-3β expressions in placenta tissue of pregnant women were detected by immunohistochemistry. Then the femoral venous blood was collected within 24 hours after birth in the study group, and the five items of hepatitis B were detected by enzyme-linked immunosorbent assay, and the newborns were divided into infected group and uninfected group according to the detection results. The expressions of GSK-3β in placenta tissue of infected group and uninfected group were compared, and the relationship between GSK-3β expression and neonatal HBV infection was analyzed. Results The positive expression rate of GSK-3β and the absorbance value of GSK-3β in placenta tissue of the study group were higher than those of the control group, and the differences were statistically significant (P? 1?×?102 copy/ml were higher than those of pregnant women with HBV-DNA titer≤ 1?×?102 copy/ml, and the differences were statistically significant (P? 1?×?102 copy/ml, positive serum HBeAg and positive expression of GSK-3β in placenta tissues were risk factors for neonatal HBV infection (OlR?=?1.956, 1.978 and 1.931, P?