人乙型肝炎免疫球蛋白定量清除新生儿乙型肝炎病毒表面抗原的研究  

Evaluation of effective doses of hepatitis B immunoglobulin to eliminate hepatitis B surface antigen from infected neonates

作　　者：张平[1] 陆伟[1] 李顺天[1] 尤炜[1] 张玉荣[1] 陈静[1] 

机构地区：[1]天津市传染病医院天津市肝病医学研究所,300192

出　　处：《中华肝脏病杂志》2012年第1期17-19,共3页Chinese Journal of Hepatology

基　　金：天津市卫生局科研基金资助项目（05KYZ96）

摘　　要：目的根据新生儿出生时HBsAg和HBV DNA的载量，调整人乙型肝炎免疫球蛋白使用量，以期更有效地阻断HBV的母婴传播。方法收集出生2h内静脉血HBsAg阳性新生儿资料125例。分为研究组64例，对照组61例，研究组根据新生儿出生时HBsAg感染量调整乙型肝炎免疫球蛋白使用量，与对照组比较新生儿12个月龄以上治疗效果。计量资料采用非正态分布采用秩和检验，计数资料采用χ^2检验。结果2组新生儿出生时HBsAg和HBV DNA检测值的差异均无统计学意义（P值均〉0．05）。研究组出生HBV感染新生儿64例，12月龄以上成功清除HBsAg者53例，成功清除率为82．8％，感染11例（1．2％）。对照组出生HBV感染新生儿61例，12月龄以上成功清除HBsAg者35例，成功清除率为57．4%，感染26例（3．1％）。2组出生HBV感染新生儿12个月龄以上清除HBsAg效果比较，χ^2=9．696，P〈0．05，差异有统计学意义。结论根据新生儿的HBsAg感染量调整使用乙型肝炎免疫球蛋白，可提高乙型肝炎母婴传播的阻断成功率。Objective To determine the effective dose of hepatitis B immunoglobulin （HBIG） for clearing maternally-transmitted hepatitis B virus （HBV） from a newborn. Me.otis Full-term neonates born to HBV-infected mothers were tested for hepatitis B surface antigen （HBsAg） and HBV DNA in venous blood, Individuals with positive results within two hours after birth were selected for study, and divided among two treatment groups： research group receiving HBIG continually adjusted to quantitative levels of neonatal HBsAg and HBV DNA levels; control group receiving standard HBIG 2001U dose. All neonates were also treated with 10 micrograms of recombinant vaccine. The decreases in HBsAg and HBV DNA over 12 months were comparatively analyzed between the two treatment groups. Results The two treatment groups （HBIG adjusted vs. standard） were statistically similar in Apgar score （9.38 ± 0.49 vs. 9.37 ± 0.48）, neonate body weight （3458.67 ± 374.93 vs. 3558.61 ± 322.85 g）, maternal age （26.33 ± 3.63 vs. 25.33 ± 3.03）, and initial HBsAg and HBV DNA levels （rank sum test Z = 1.381, and Z = 0.700, respectively） （all, P 〉 0.05）. Successful clearance of HBV infection within 12 months was achieved in significantly more neonates in the HBIG adjusted therapy group than in the standard therapy group （82.8% vs. 57.4%; χ^2 = 9.696, P 〈 0.05）. Conclusion Adjusting the neonatal HBIG dose according to HBsAg and HBV DNA levels can improve the success rate of clearing maternally-transmitted HBV.

关 键 词：肝炎病毒 乙型 肝炎E抗原 乙型 治疗 

分 类 号：R722[医药卫生—儿科]