乙型肝炎抗原抗体定量测定在阻断母婴宫内传播中的意义  

A study for the significance of the titer of hepatitis B virus antigen and antibody in interrupting the hepatitis B virus intrauterine transmission

作　　者：陈红[1] 何逸文[2] 卢新[3] 

机构地区：[1]北京市海淀区妇幼保健院儿科,100080 [2]北京市海淀区妇幼保健院产科,100080 [3]北京市海淀区妇幼保健院检验科,100080

出　　处：《中国新生儿科杂志》2008年第5期276-279,共4页Chinese Journal of Neonatology

基　　金：北京市卫生局妇幼科研基金资助项目(C03011403)

摘　　要：目的探讨孕妇乙型肝炎病毒(HBV)抗原抗体定量测定在阻断乙型肝炎病毒宫内传播中的意义。方法我院分娩的乙肝表面抗原(HBsAg)阳性、乙肝核心抗体(HbcAb)阳性、乙肝e抗原(HBeAg)阴性孕产妇445例及其分娩的新生儿445例作为观察对象。其中孕产妇乙肝e抗体(HBeAb)阳性349例(作为干预1、2组和对照1组),HBeAb阴性96例(作为对照2组)。⑴干预1组:孕妇孕28、32、36周共3次肌肉注射乙肝免疫球蛋白(HBIG)200IU,共133例。⑵干预2组:孕妇孕20～27周检测静脉血HBsAg、HBeAb和HBcAb定量,HBeAb定量大于50ncu/ml者孕28、32、36周分别肌肉注射HBIG400IU,共124例。⑶对照1组:孕期未注射HBIG,共92例。⑷对照2组:孕期未注射HBIG,共96例。检测各组孕妇的新生儿生后12h内静脉血HBV抗原定性。结果干预2组孕妇46例(37.1%)HbsAg升高、41例(33.1%)HbcAb升高;新生儿HBV定性,干预1组阳性2例(1.5%),对照1组阳性4例(4.3%),两组之间阳性率对比(χ2=1.695,P=0.193)差异无统计学意义,干预2组和对照2组无HBV定性阳性。结论孕妇HBsAg和HBcAb定量值高者未见宫内传播者。孕妇HBeAb定量值低者未见宫内传播者。HBeAb定量值高的孕妇分娩HBV定性阳性新生儿的可能性大,故可作为HBIG阻断宫内传播对象的参考。HBeAb定量增高与宫内传播关系的探讨目前是初步的,尚待继续深入研究。Objective To study the significance of the titer of hepatitis B virus （HBV） antigen and antibody in interrupting the intrauterine transmission of hepatitis B virus. Methods 445 neonates whose mothers were hepatitis B surface antigen （HBsAg） positive were recruited. They were divided into 4 group. In the treatment group 1, there were 133 newborns whose mothers were positive in the HBsAg, hepatitis B e antibody （HBeAb） and the hepatitis B core antibody （HBcAb） test, their mother were given intramuscular injection of HBIG 200 units once each in gestational age of 28 week, 32 week and 36 week. In the treatment group 2, there were 124 newborns whose mothers were positive in HBsAg, HBeAb and HBcAb test and the titer of HBsAg, HBeAb and HBcAb were checked during 20 to 27 gestational week. When the titer of HBeAb was above 50 cu/ml, the mothers were given intramuscular injection of HBIG 400 units once each in gestational age of 28 week and 32 week and 36 week. In the control group 1, there were 92 newborns whose mothers were HBsAg, HBeAb and HBcAb positive, they did not receive HBIG injection during pregnancy. In the control group 2, there were 96 newborns whose mothers were HBsAg, HBcAb positive and HBeAb negative, they also did not receive HBIG injection during pregnancy. Within 12 hours after birth, the venous HBV antigens were checked in newborns in each group. Results In the treatment group 2, there were 46 cases pregnant women whose HBsAg was high （37.09%） and 41 cases pregnant women whose HbcAb was high （33.06%）. In the treatment group 1, there were 2 newborns who were hepatitis B virus （HBV） positive （ 1.5% ）. In the control group 1, there were 4 newborns who were HBV positive （4. 3 % ）, there was no significant difference （χ^2 = 1. 695, P = 0. 193 ）. In the treatment group 2 and control group 2, there was no newborn who was HBV positive. Conclusion There was no HBV intrauterine transmission in the pregnant women with high titer of HBsAg and HBcAb. There was no HBV intraut

关 键 词：肝炎 乙型 抗原抗体反应 疾病传播 垂直 

分 类 号：R446.6[医药卫生—诊断学] R512.6[医药卫生—临床医学]