目的:探讨不同分娩方式对乙型肝炎病毒母婴垂直传播的影响。方法:收集在暨南大学附属第一医院正规产检并且足月分娩的乙肝表面抗原阳性孕妇68例(乙肝组)及同期分娩的乙肝表面抗原阴性孕妇64例(对照组)。乙肝组分别检测不同分娩方式临产前母血乙肝病毒标记物、胎盘型碱性磷酸酶、HBV-DNA含量;同时采集脐带血检测胎盘型碱性磷酸酶及HBV-DNA含量,采集新生儿出生后1天内外周血检测乙肝病毒标记物及HBV-DNA含量。对照组分别在临产前及分娩后采集孕妇外周血及脐带血定量检测胎盘型碱性磷酸酶。结果:乙肝组和对照组的选择性剖宫产胎儿脐血中胎盘型碱性磷酸酶含量均低于顺产组,差异有统计学意义(P<0.05)。乙肝组不同分娩方式的新生儿外周血HBV-DNA、HBsAg均为阴性,HBeAg阳性率差异无统计学义(P>0.05)。结论:选择性剖宫产比顺产更能减少母血向胎儿血的渗透量。 Objective: To investigate the effect of different modes of delivery on the vertical transmission of hepatitis B virus in mother and infant. Methods: Sixty-eight HBsAg positive pregnant women (group B) and 64 HBsAg negative pregnant women (control group) were enrolled in the First Affiliated Hospital of Jinan University. Hepatitis B virus markers, placental alkaline phosphatase and HBV-DNA content in different modes of delivery were detected in hepatitis B group. Cord blood samples were collected to detect placental alkaline phosphatase and HBV-DNA content, Peripheral blood samples were tested for HBV markers and HBV-DNA levels within 1 day. Control group were collected before labor and after delivery of pregnant women, peripheral blood and umbilical cord blood placental quantitative detection of placental alkaline phosphatase. Results: The levels of placental alkaline phosphatase in cord blood of selective cesarean section in hepatitis B group and control group were significantly lower than those in the normal group (P <0.05). HBV-DNA and HBsAg in neonates with different modes of delivery in HBV group were all negative, and there was no significant difference in HBeAg positive rate (P> 0.05). CONCLUSIONS: Selective cesarean delivery is more effective in reducing the amount of maternal blood infiltrating into the fetus than in the cesarean section.