婴儿出生时乙型肝炎e抗原对联合免疫应答的影响  

The influence of HBeAg in new born infants on the response to anti-hepatitis B immunoglobulin combined with hepatitis B vaccination

作　　者：岳欣[1] 江红秀[1] 韩国荣[1] 阚乃颖[1] 王艳[1] 

机构地区：[1]东南大学附属第二医院妇产科,南京210003

出　　处：《中华传染病杂志》2013年第7期413-416,共4页Chinese Journal of Infectious Diseases

基　　金：江苏省自然基金重点项目（BK2010026）

摘　　要：目的探讨婴儿出生时HBeAg对联合免疫应答效果的影响。方法选取2008年1月至2011年1月在东南大学附属第二医院妇产科出生时HBeAg阳性非宫内感染婴儿120例作为研究组，另选取HBeAg阴性88名婴儿为对照组，两组婴儿在出生即刻及出生后15d注射乙型肝炎免疫球蛋白200IU，并按常规分别在婴儿出生时（O）、1和6个月注射基因重组乙型肝炎疫苗（CHO细胞）20Mg。所有婴儿于出生后未免疫预防前采血检测HBV血清学标志物、HBVDNA定量，出生后1、7、12个月采集静脉血，检测HBsAg、HBeAg和抗-HBs确定免疫应答效果。计数资料采用y。检验，组间比较采用t检验。结果研究组婴儿1、7和12个月抗-HBs滴度与对照组比较，差异均无统计学意义（t值分别为1．285、0．563和-0．971，均P〉0．05）。1个月时两组抗-HBs较基线升高（P〈O．05），完成联合免疫接种7个月时两组抗-HBs滴度高于1个月，12个月时两组抗-HBs较7个月时降低，但仍明显高于1个月龄滴度（F值分别为34．3959、64．908；均P〈O．01）。研究组婴儿出生时HBeAg滴度中位数为47．495s／co，依此再分为高于中位数组和低于中位数组，两组婴儿抗HBs滴度在1、7、12个月比较，差异均无统计学意义（均P〉0．05）。研究组婴儿血清中HBeAg逐渐下降，至7个月时仅3例婴儿HBeAg阳性，随访至12个月时3例婴儿HBeAg均转阴，在HBeAg消减过程中，无-例婴儿产生抗-HBe。结论联合免疫预防后婴儿HBeAg阳性与否对婴儿抗-HBs的产生无影响。Objective To study the effects of HBeAg in new born infants on the response to anti-hepatitis B immunoglobulin combined with hepatitis B vaccination. Methods Two hundred and eight infants who were born during January 2008 to January 2011 in the Department of Obstetrics in Second Affiliated Hospital of Southeast University, including 120 serum HBeAg positive infants without intrauterine infection, and 88 HBeAg negative infants as control group were recruited in the study. Infants in both groups were vaccinated with genetically engineered hepatitis B vaccine （CHO cell） 20 μg according to a standard vaccination regimen （i. e. 0,1,6） and 200 IU doses of hepatitis B immunoglobulin immediately after birth and at day 15 respectively. Hepatitis B virus （HBV） serological markers and HBV DNA were measured at birth prior to immunization. HBsAg, HBeAgand hepatitis B surface antibody （anti-HBs） were detected at 1,7, and 12 months after birth to evaluate the effects of immune response. The date were analyzed by the chi square test and groups were analyzed by t test. Results No statistical significances of anti-HBs were observed between the serum HBeAg positive group and the serum HBeAg negative group at the lst,7th and the 12th month of birth （t=1.285, 0. 563 and --0. 971, respectively all P〉0. 05）. The anti-HBs titers in both groups at 1 month were higher than at birth （P〈0.05）. At 7 months after birth, the anti-HBs titers in both groups were even higher than those at 1 month. At 12 months after birth, the anti HBs titers in both groups were lower than those at 7 months, but still higher than those at 1 month（F=34. 3959 and 64. 908, respectively; both P〈0.01）. Infants who were born with positive serum HBeAg were further divided into two subgroups according to the HBeAg titers, using the median HBeAg titer （47. 495 S/CO） as the cut off point. Between the two subgroups, there were also no significant differences of anti-HBs at 1 month, 7 months and 12 months （all P〈0.05）. The HBeAg t

关 键 词：肝炎病毒 疾病传播 水平 肝炎E抗原 乙型 肝炎抗体 婴儿 新生 免疫球蛋白类 肝炎疫苗 

分 类 号：R725.1[医药卫生—儿科]