双剂量乙肝免疫球蛋白联合乙肝疫苗阻断乙肝母婴传播的效果调查  

Protective effect of Hepatitis B vaccine combined with two-dose Hepatitis B immunoglobulin on infants born from HBsAg-positive mothers.

作　　者：吴限[1] 高夕雷[1] 孙文[1] 吴凤会[1] 钱雷[1] 

机构地区：[1]滨海县人民医院,江苏盐城224500

出　　处：《海南医学》2012年第21期11-13,共3页Hainan Medical Journal

摘　　要：目的回顾性调查分析乙肝表面抗原(HBsAg)阳性孕妇所生的婴儿经联合接种乙肝疫苗和双剂量200IU乙肝免疫球蛋白(HBIG)后产生的预防效果。方法研究对象为320例HBsAg阳性孕妇所生的婴儿,出生后联合接种10mg乙肝疫苗(0、1、6个月)和双剂量200IU HBIG(0、2周),出生后第7个月检测婴儿血液HBsAg和抗HBs浓度。结果 2.8%的婴儿(9/320)乙肝免疫预防失败(HBsAg阳性),2.5%的婴儿(8/320)呈免疫应答无反应(抗HBs浓度<10IU/L),94.7%的婴儿(303/320)免疫应答有反应(抗HBs≥10IU/L)。HBeAg阴性和HBeAg阳性孕妇所生的婴儿免疫接种失败率分别为0%和5.17%(P<0.05),HBV DNA阴性和HBV DNA阳性孕妇所生的婴儿免疫接种失败率分别为0%和4.41%(P<0.05),但母亲HBeAg和HBV DNA阳性与婴儿对乙肝疫苗无免疫应答不相关(P>0.05)。结论通过联合乙肝疫苗和双剂量200IUHBIG接种,绝大多数婴儿(94.7%)在出生后第7个月可产生保护性抗体,母亲HBeAg和HBV DNA可影响婴儿的乙肝免疫预防失败率,但与婴儿对乙肝疫苗免疫应答无反应不相关。Objective To investigate the protective effect of Hepatitis B vaccine combined with two-dose Hepatitis B immunoglobulin on infants born from HBsAg-positive mothers. Methods Three hundred and twenty infants from HBsAg-positive mothers were included. All the infants were given three doses of 10 mg HB vaccine （at 0, 1 and 6 months of age） and two-dose of 200 IU HBIG （at birth and in 2 weeks of age）. Serum HBsAg and antibody to HBsAg （anti-HBs） in all the infants were determined at 7 months of age. Results Among the 320 infants, 2.8% infants were immunoprophylaxis failure （positive for HBsAg）, 2.5% infants did not response- （anti-HBs 10 IU/L）, and 94.7% infants responsed. The immunoprophylaxis failure rate was at 0% and 5.17% for the infants of HBeAg-negative and HBeAg-positive mothers （P0.05）. Infants from mothers with detectable HBVDNA had higher incidence of immunoprophylaxis failure than those of mothers without detectable HBV DNA （4.41% vs 0%, P0.05）. Maternal HBeAg-positive and HBV DNA detectable were not associated with the non-response to HB vaccination （P0.05）. Conclusion Through vaccination by three doses of HB vaccine and two-dose of HBIG, the majority of infants achieved a protective level of anti-HBs at 7 months of age. Maternal HBeAg and HBV DNA contribute to the immunoprophylaxis failure, but not contribute to the no response to HBV vaccination.

关 键 词：乙肝疫苗 乙肝免疫球蛋白 

分 类 号：R373.2[医药卫生—病原生物学]