乙肝免疫球蛋白阻断高乙肝病毒载量孕妇母婴传播研究  

Effect of Hepatitis B Immunoglobulin Blocking High Hepatitis B Viral Load on Mother-to-child Transmission for Pregnant Women

作　　者：周影[1] 赵勇[2] 包淑平[1] 齐玉玲[3] 

机构地区：[1]辽宁医学院附属第一医院传染科 [2]辽宁医学院生化教研室 [3]辽宁医学院附属第一医院妇产科,辽宁锦州121001

出　　处：《辽宁医学院学报》2013年第3期19-21,共3页Journal of Liaoning Medical University (LNMU) Bimonthly

基　　金：辽宁省教育厅基金资助项目;编号:L2010314

摘　　要：目的探讨乙肝免疫球蛋白(HBIG)阻断高乙肝病毒(HBV)载量孕妇母婴传播。方法 2009年1月至2012年5月筛选我院高HBV载量孕妇139例:HBsAg、HBeAg和(或)抗HBe和抗HBc阳性、HBV-DNA≥1.0×107拷贝/毫升。随机分观察组79例和对照组60例。观察组孕妇28、32、36 w肌注HBIG200 U,对照组孕期不采取特殊措施。两组新生儿出生6小时内肌注HBIG100IU,乙肝疫苗全程接种,采集出生、7个月及1周岁时静脉血,检测HBsAg、抗HBs、HBeAg、抗HBe、抗HBc和HBV-DNA。结果观察组婴儿出生、7个月龄及1周岁时HBV感染率分别为10.1%、8.9%及8.9%,低于对照组31.7%、23.3%及23.3%,两组数据间差异具有统计学意义(P<0.05)。新生儿保护性抗体(抗HBs)获得率出生时观察组38%,高于对照组6.7%,两组差异有统计学意义(P<0.05);出生1年观察组77.2%,高于对照组66.7%,但两组差异无统计学意义(P>0.05)。结论高HBV载量孕妇孕末期应用HBIG可提高HBV母婴传播阻断率及新生儿出生时抗体保护率,但对提高新生儿出生1年抗体保护率无效。Objective To investigate the effect of hepatitis B immune globulin （HBIG） blocking high hepatitis B vi- ral （HBV） load on mother - to - child transmission for the pregnant women. Methods 139 cases of pregnant women with high HBV load in our hospital were chosen from January 2009 to May 2012, including HBsAg, HBeAg, （and/or） anti - HBe and anti -HBc positive and HBV -DNA≥1.0 × 107 copies / ml. They were randomly divided into the observation group of 79 cases and the control group of 60 cases. The pregnant women in the observation group were injected with HBIG 200 U in the 28th, 32nd and 36th weeks of pregnancy. No special measures were taken to the control group during preg- nancy. The newborns of the two groups were injected with HBIG 100 IU within 6 hours after birth and vaccinated Hepatitis B vaccine. Venous blood of newborns in the two groups were collected at birth, 7 months old and 1 year old and HBsAg, anti -HBs, HBeAg, anti -HBe, anti -HBc and HBV -DNA were tested. Results The HBV infection rates of infants in the observed group at birth, 7 months old and 1 year old were 10. 1%, 8.9% and 8.9% respectively, lower than those in the control group, which were 31.7%, 23.3% and 23.3%. The difference was statistically significant （P 〈 0. 05 ） be- tween the two sets of data. The neonatal anti - HBs protection rate in the observed group at birth was 38%, 6. 7% higher than that in the control group. The difference was statistically significant （ P 〈 0. 05 ）. One year later it was 77.2%, 66.7% higher than that in the control group. But the difference was not statistically significant （P 〉 0. 05 ）. Conclusion The application of HBIG for pregnant women with high HBV load during late pregnancy can increase the rate of blocking mother - to - child transmission of HBV and the infant anti - HBs protection rate at birth, but it is ineffective to improve anti - HBs protection rate after a year.

关 键 词：乙肝免疫球蛋白 高乙肝病毒载量 母婴传播 阻断 

分 类 号：R512.6[医药卫生—内科学]