不同方案阻断乙肝病毒母婴垂直传播的临床研究  

Clinical study on preventing mother - infant vertical transmission of hepatitis B virus

作　　者：王清图[1] 修霞[1] 郭永[1] 陶华娟[1] 

机构地区：[1]潍坊市妇幼保健院,山东潍坊261011

出　　处：《临床肝胆病杂志》2002年第1期51-52,共2页Journal of Clinical Hepatology

摘　　要：探讨阻断乙型肝炎病毒母婴垂直传播的方法．将 １２２例 ＨＢｓＡｇ（＋）孕妇分成四组，ＨＢＶａｃ治疗组 ２９例，ＨＢＩＧ组２９冽，左旋咪唑涂布剂与以上两者联合应用３０例．未治疗组３４例、均在孕２６周开始干预观察，孕妇和新生儿血清ＨＢＶ标志物（ＨＢＶＭ）检测采用ＥＬＩＳＡ法。１２２例孕妇按分娩方式不同分别观察对乙肝病毒母婴垂直传播影响；随访产妇及新生儿ＨＢＶＭ变化。脐血中ＨＢｓＡｇ阳性率：ＨＢＶａｃ冶疗组为１７．２４％，ＨＢＩＧ治疗组为１０．３５％，联合治疗组为３．３３％，未治疗组为２３．５３％．在不同的分娩方式中，急症剖宫产新生儿脐血ＨＢｓＡｇ阳性率为１３．０４％．行择期剖宫产者为０，经阴道分娩者为１６．６７％。携带ＨＢＶ孕妇于孕晚期给予ＨＢＶａｃ、ＨＢＩＧ和左旋咪唑涂布剂联合以上两者治疗后，可有效阻断母婴之间传播。以联合治疗组效果最佳。不同分娩方式也影响传播，剖宫产术有助于阻断ＨＢＶ母婴传播。To probe preventing methods on mother - infant vertical transmission of Hepatitis B virus, 122 pregnant women with HBsAg positive were divided into four groups. 29 cases were injected with hepatitis B vaccine, 29 cases were injected with hepatitis B immunoglobulin (HBIG); 30 cases were used levamisole liniment combined with injection of both HBV ac and HBIG during pregnancy since the 26th week of gestation; and 30 cases was regarded as control group without any treatment. Serologic HBV markers (HBVM) of pregnant women and newborns umbilical blood were detected by ELISA. These women were divided into two groups by delivery manner. HBsAg positive rate of newborns umbilical blood were different among three treated groups: 17.24% for HBVac group.10. 35% for HBIG group.3. 33% for HBVac and HBIG and levamisole liniment group. By different delivery manier, infection rate of emergent caesarean section, selected caesarean section and vaginal delivery were 13. 04%, 0, and 16. 67%, respectively. Immunization with HBVac or HBIG or both add levamisole liniment during pregnany may prevent intrauterine HBV infection effectively. In order to decrease transmission of mother - infant, selected caesarean birth should be adopted.

关 键 词：乙型肝炎病毒 母婴垂直传播 左旋咪唑涂布剂 剖中产 宫内感染 

分 类 号：R173[医药卫生—妇幼卫生保健]