乙肝疫苗和免疫球蛋白阻断乙肝母婴传播效果研究  

Study on hepatitis B vaccine and HBIG's effect on preventing HBV transmission from mother to child during pregnancy

作　　者：宋婷婷[1] 单芙香[2] 程锦泉[2] 尹平[1] 

机构地区：[1]华中科技大学同济医学院公共卫生学院流行病与卫生统计学系,湖北武汉430030 [2]深圳市疾病预防控制中心,广东深圳518000

出　　处：《中华疾病控制杂志》2011年第6期497-499,共3页Chinese Journal of Disease Control & Prevention

基　　金：深圳市科技计划项目(201002094)

摘　　要：目的了解乙肝疫苗和乙肝免疫球蛋白阻断乙肝母婴传播的效果及乙肝母婴传播的影响因素。方法从深圳市3家医院随机抽取HBsAg阳性产妇中其新生儿已接种乙肝疫苗和乙肝免疫球蛋白者共158对,随访调查母亲乙肝感染情况、分娩和喂养方式等,并检测婴幼儿血清中HBsAg和HBsAb水平。结果调查婴幼儿中,HBsAg阳性率为6.96%,HBsAb阳性率为56.33%。不同年龄组间HBsAg阳性率差异无统计学意义(P>0.05),但HBsAb阳性率差异有统计学意义(χ2=11.759,P=0.008)。母亲为乙肝大三阳和小三阳所生的婴幼儿HBsAg阳性率分别为14.29%和2.94%,两者差异有统计学意义(P<0.05)。母亲孕期接种和未接种乙肝免疫球蛋白的婴幼儿HBsAg阳性率分别为8.57%和7.77%,顺产和剖腹产婴幼儿HBsAg阳性率分别为9.68%和3.08%,母乳喂养和人工喂养婴幼儿HBsAg阳性率分别为6.45%和7.69%,上述差异均无统计学意义(P>0.05)。结论在本研究中,婴幼儿接种乙型肝炎疫苗和乙肝免疫球蛋白可以有效降低HBV垂直传播率;阻断效果与母亲是否患大三阳有关,与是否接种乙肝免疫球蛋白、生产及喂养方式无关。Objective To investigate the effects of the hepatitis B vaccine and HBIG on HBV mother-to-child transmission blocking and the influencing factors of HBV mother-to-child transmission.Methods 158 pregnant women with positive hepatitis B surface antigen（HBsAg） were selected as the study subjects from three hospitals in Shenzhen City.Babies borned by study subjects had been inoculated with HBIG at brith and hepatitis B vaccine at 0,1 and 6 months of age.The study subjects were investigated to get the information of the maternal infection situation of hepatitis B,the dilivery method and the feeding method.The infants＇venous blood was collected to test the level of HBsAg and HBsAb in serum.Results The positive rates of HBsAg and HBsAb in infants were 6.96% and 56.33% respectively.No significant difference was found for the positive rate of HBsAg（P〉0.05）,but a significant difference was found for the positive rate of HBsAb among different age groups（χ2=11.759,P=0.008）.The HBV infection rate was higher for infants whose mothers were with positve HBsAg（14.29%/2.94%）,HBeAg and HBcAb compared with those with mothers carrying positive HBsAg and HBcAb（P〈0.05）.The positive rates of HBsAg in infants whose mothers had been inoculated with HBIG or not during pregnancy were 8.57% and 7.77% respectively,without significant difference between them（P〉0.05）.There was no significant difference for the positive rates of HBsAg in infants whose mothers choosing cesarean section（9.68%） or natural delivery（3.08%）.Regarding different feeding methods,there were also no significant difference found for the positive rates of HBsAg in infants（6.45%/7.69%）.Conclusions In current study,inoculating hepatitis B vaccine and HBIG in infants have significant effects on blocking HBV mother-to-child transmission.The blocking effect is significantly associated with the infection status of HBV in mothers.No relationship was found between the blocking effect and the situation of inoculating HBIG during pregnancy,

关 键 词：肝炎病毒 乙型 免疫球蛋白类 疾病传播 垂直 

分 类 号：R181[医药卫生—流行病学] R512.62[医药卫生—公共卫生与预防医学]