HBeAg阴性乙肝病毒携带孕妇孕晚期使用HBIG阻断HBV宫内感染的Meta分析  

Hepatitis B immunoglobulin injection in late pregnancy for HBeAg- negative carrier mothers to interrupt hepatitis B virus intrauterine infection: a meta analysis

作　　者：费满冬[1] 李卉[1] 王琼[1] 黄源[1] 李畅畅[1] 黄蓉[1] 李佳圆[1] 

机构地区：[1]四川大学华西公共卫生学院(华西第四医院),四川成都610041

出　　处：《现代预防医学》2013年第16期2987-2990,2995,共5页Modern Preventive Medicine

摘　　要：目的综合评价HBeAg阴性乙肝病毒携带孕妇孕晚期使用乙肝免疫球蛋白(HBIG)用于阻断HBV宫内感染的有效性。方法系统性收集2000年至今中国HBeAg阴性乙肝病毒携带孕妇孕晚期使用HBIG的相关文献;按照JADAD标准对纳入文献进行质量评价;采用Revmen5.1软件进行数据分析,得到合并RD值及其95%CI。结果最终纳入了12个RCT研究,共1826例孕妇。Meta分析结果显示:干预组相比于对照组,孕晚期注射HBIG能有效地降低HBV的宫内感染(RD=-0.18,95%CI(-0.11～-0.04),P﹤0.0001)。按宫内感染的不同诊断标准"以新生儿出生后24h内在接种疫苗和HBIG以前检测外周血中HBsAg阳性为宫内感染"和"以新生儿出生后即可检测外周血中HBsAg阳性并持续3个月以上为阳性即宫内感染"进行亚组分析发现,在各亚组中,干预组与对照组比较,宫内感染差异有统计学意义,RD(95%CI)分别为-0.10(-0.15～-0.04)和-0.05(-0.09～-0.02)。结论 HBeAg阴性乙肝病毒携带孕妇孕晚期使用HBIG能有效阻断母婴间HBV宫内感染。OBJECTIVE To evaluate the efficiency of using hepatitis B immunoglobulin （HBIG） during late pregnancy to prevent hepatitis B virus intrauterine infection for HBeAg-negative carrier mothers. METHODS According to the criteria for inclusion, literatures about HBIG in interruption of mother-to-infant transmission of HBV from 2000 to now were searched extensively and then assessed with JADAD＇s standard. We used Meta-analysis software, Revman 5.1, to test the heterogene- ity of the researches, and calculate the pooled ratio difference （RI）） with 95%CI. Sensitivities of the results were analyzed, and publication bias was evaluated by Egger＇s test. RESULTS A total of 1826 newborns of asymptomatic HBsAg-positive but HBeAg-negative carrier mothers from 12 qualified RCTs were included. Compared with control group, newborns in HBIG group had a lower intrauterine infection rate （RD = -0.18, 95%CI： -0.11- -0.04, P 〈 0.0001）. In subgroups, stratified by different diagnosis standard of intrauterine infection, Standard 1 （HBsAg-positive in peripheral blood of neonate before injec- tion of HBV vaccine and Hepatitis B immunoglobulin） and Standard 2 （HBsAg-positive in peripheral blood lasts for positive for more than three months from born）, we found that there were obviously differences of intrauterine infection rate between intervention group and control group in any subgroups （Merger effect value, RD （95%CI）; -0.10 （-0.15- -0.04） for Standard land -0.05 （-0.09- -0.02） for Standard 2）. CONCLUSION Multiple injection of HBIG in HBeAg-negative HBV carrier mothers in late pregnancy can prevent HBV intrauterine transmission effectively and safely.

关 键 词：HBEAG阴性 META分析 乙肝免疫球蛋白 宫内感染 

分 类 号：R735.7[医药卫生—肿瘤]