66例乙肝父婴垂直传播新生儿的随访观察  

Follow-up observation of 66 cases of vertical transmission from HbsAg-positive father to infant

作　　者：陈起燕[1] 张荣莲[1] 任坤海[1] 修晓燕[1] 黄欣欣[1] 

机构地区：[1]福建医科大学福建省妇幼保健院教学医院,福建福州350001

出　　处：《中国妇幼保健》2013年第2期236-238,共3页Maternal and Child Health Care of China

基　　金：福建省自然科学基金项目〔2011J01124〕;福建省医学创新课题〔2011-cxb-17〕

摘　　要：目的:探讨父亲单方为乙肝病毒感染者所分娩的新生儿脐带血HBV-DNA阳性经乙肝疫苗或乙肝疫苗与乙肝免疫球蛋白联合免疫后的阻断效果。方法:对66例脐带血HBV-DNA阳性的新生儿(由父亲HBsAg阳性,母亲血清HBVM及HBVDNA均为阴性的306个家庭)随访其经乙肝疫苗或乙肝疫苗与乙肝高效免疫球蛋白联合免疫后的阻断效果,随访时间为出生后7、9、12个月跟踪检测乙肝表面标志物的情况。结果:父亲单方为乙肝病毒感染者的新生儿HBV阳性率为21.6%;随访到12个月时,其新生儿HBV阳性者中HBsAg阳性率为9.1%;父亲HBVM不同结果与不同免疫干预的子代产生保护抗体的起始时间基本上均在婴儿出生后9个月,仅父亲为小三阳的这一组有27.3%在生后12个月产生保护性抗体。结论:母亲HBV标志物及HBV-DNA均为阴性,父亲为大三阳或小三阳所生的新生儿要按母亲HBV感染一样提供24 h内的乙肝高效免疫球蛋白免费接种;对生后9个月内的婴儿应加强防护,避免在保护性抗体未出现前过多地接触各种可能的血液体液暴露。Objective： To explore the blocking effect on hepatitis B vaccine or hepatitis B vaccine and hepatitis B immunoglobulin joint immune by follow - up the cases of father for hepatitis B virus infection unilaterally during newborns cord blood HBV - DNA positive. Methods ： Adopted 66 cases of newborns of cord blood HBV - DNA positive from 306 families, which father was HbsAg positive but mother was HbsAg and HBV - DNA negative. Follow - up the blocking effect on hepatitis B vaccine or hepatitis B vaccine and hepatitis B immunoglobulin joint immune in 7, 9, 12 months after birth by testing baby~ HBVM. Results： Neonate HBV positive was 21.6% from 306 families. In 12 months after birth, offspring HbsAg positive was 9. 1% from 66 cases. Father~ different HBVM results with different im- mune intervention the progeny of protection antibody produced the start time of basically were in 9 months after birth. Only 27. 3% infants in group of the father with positive HBsAg, HBeAb and HBcAb produced protective antibody in 12 months after birth. Conclusion： Neonates whose mother with both negative of I-IBV markers and HBV - DNA , but the father with positive HBsAg, HBeAg and HBcAb or positive HBsAg, HBeAb and HBcAb are provided efficient immunoglobulin free vaccination within 24 hours after birth, like those whose mother with positive HBsAg, HBeAg and HBcAb or positive HBsAg, HBeAb and HBcAb. Infants within 9 months after birth should be strengthened the protection, avoid all possible exposure to body fluids before protective antibody appearance.

关 键 词：乙型肝炎病毒 父婴传播 新生儿 随访观察 

分 类 号：R174[医药卫生—妇幼卫生保健]