预防免疫对阻断乙型肝炎父婴传播的临床研究  

CLINICAL STUDY ON PREVENTION IMMUNIZATION OF PATERNAL-FETAL TRANSMISSION OF HEPATITIS B VIRUS

作　　者：王彩霞 靳军 

机构地区：[1]浙江省温州市龙湾区第一人民医院,温州325024

出　　处：《现代预防医学》2007年第8期1589-1590,共2页Modern Preventive Medicine

摘　　要：[目的]探讨阻断乙型肝炎病毒父婴传播的方法。[方法]选取2003年1月～2006年1月,100例孕妇丈夫血清HBV DNA(+),孕前抗-HBs(+)孕妇的病例为研究对象(观察组),并根据孕期是否肌注乙肝免疫球蛋白分2组:Ⅰ组孕期自孕24周产检起,每4周肌注乙肝免疫球蛋白200IU至分娩,Ⅱ组孕期不肌注乙肝免疫球蛋白。另筛选出孕妇无各种肝炎病毒感染,而丈夫血清HBV DNA(+)的病例为对照组(Ⅲ组)。3组病例新生儿出生时均抽脐带血检测HBV DNA及抗-HBs。[结果]观察组Ⅰ组新生儿抗-HBs(+),阳性率为56.00%(28/50),观察组Ⅱ组新生儿抗-HBs(+)阳性率为52.00%(26/50);对照组新生儿抗-HBs(+)为O(0/45)无一例阳性。观察组抗-HBs(+)率显著高于对照组(P﹤0.05)。Ⅰ组脐血HBV-DNA(+)16.00%(8/50),Ⅱ组有18.22%(9/50),Ⅲ组有42.22%(19/45)。观察组新生儿感染率明显低于对照组。[结论]孕前成功获得抗-HBs(+),可有效阻断父婴传播;孕期加用HBIG未能进一步阻断父婴传播。[ Objective] To study the way of blocking the paternal-fetal transmission of hepatitis B virus （HBV） . [Methods] From January 2003 to January 2006. 100 couples of men with serum HBV-DNA positive and women with antiHBs spositive were selected and assigned into study group Ⅰ and group Ⅱ. Women in group Ⅰ was injected with hepatitis B specific immunoglobulin 200 IU monthly since the 24th week in duration of pregnancy; 50 couples of men with serum HBV DNA positive and women without hepatitis virus infection were selected as control group （ Ⅲ ） . The anti-HBs and HBV DNA of the neonates in the three groups were all determined after birth by testing the serum of cord blood. [ Results] Positive rate of anti-HBs of infants in group Ⅰ, group Ⅱand group Ⅲ were 56.00% （28/50）, 52.00% （26/50）, 0.00% respectively; the positive rate of anti-HBs in study group was obviously higher than that in control group. 16.00% （6/50） of neonates in group Ⅰ and 18.22% （9/50） of neonates in group Ⅱand 42.22% （19/45） of neonates in group Ⅲ were infected by HBV. The infection rate of HBV in study group was significantly lower than that in control group （P〈 0.05） . [Conclusions] Successful passive immunity before pregnancy is an important way to block the paternal-fetal transmission of HBV. It isn＇t effective to block the paternal-fetal transmission of HBV that injecting with HBIG during pregnancy.

关 键 词：乙型肝炎病毒 父婴传播 预防疫苗 

分 类 号：R373.21[医药卫生—病原生物学]