孕妇主动与被动联合免疫预防乙型肝炎病毒宫内感染的临床研究  

Clinical Study of Preventing HBV Intrauterine Infection by Active and Passive Immunization of Pregnant Women

作　　者：岳亚飞[1] 李银姬[2] 张树林[3] 

机构地区：[1]西安医科大学第一临床医学院妇产科,710061 [2]大连市妇产医院 [3]西安医科大学第一临床医学院,710061

出　　处：《中华围产医学杂志》2000年第1期3-5,共3页Chinese Journal of Perinatal Medicine

摘　　要：目的　探讨孕妇主动与被动联合免疫预防乙型肝炎病毒 (H BV)宫内感染的作用和机理。　方法　将 5 3例 H Bs Ag(+)孕妇分成两组 ,预防组 30例 ,自孕 2 0周起多次注射乙肝疫苗(HBVac)和乙肝免疫球蛋白 (HBIG) ;对照组 2 3例 ,不用 HBVac和 HBIG。母儿血清 HBs Ag、HBe Ag和抗 - HBs用固相放免法检测 ,HBV- DNA用套式 PCR检测。　结果　预防组新生儿血清 HBs Ag和HBV - DNA检出率明显低于对照组 (3.3%与 2 6 .1% ,10 %与 34 .8% ) P均 <0 .0 5 ;预防组新生儿抗 -HBs阳性率显著高于对照组 (33.3%与 8.7% ) P<0 .0 5。　结论　孕妇于孕期通过 HBIG和 HBV ac免疫 ,可有效预防 HBV宫内感染 ,其机理可能为胎儿获得被动免疫。Objective To study the efficacy and possible mechanism of active and passive immunization during pregnancy in preventing intrauterine HBV infection. Methods Fifty three pregnant women with HBsAg positive were devided into two groups. In the prevention group,30 cases were injected with hepatitis B vaccine(HBVac) and hepatitis B immunoglobulin(HBIG) during pregnancy since the 20th week of gestation) In the control group,23 cases without injection of HBVac or HBIG. HBsAg, HBeAg and anti HBs were tested with solid phase radio immunoassay and HBV DNA in serum was detected with nested polymerase chain reaction in maternal and neonates. Results The detection rate of HBsAg and HBV DNA in the newborns of prevention group was significantly lower than that of the control group, (3.3% vs 26.1%, 10% vs 34.8%, P <0.05, respectively); the detection rate of anti HBs was significantly higher in the newborns of the prevention group than that of the control group, (33.3% vs 8.7% P <0.05). Conclusion\ Immunization with HBVac and HBIG during pregnancy may prevent intrauterine HBV infection effectively and its mechanism may be that the fetuses acquire passive immunization.

关 键 词：妊娠合并症 乙型肝炎 疾病垂直传播 预防 

分 类 号：R715.3[医药卫生—妇产科学]