乙型肝炎病毒感染孕妇母婴传播采取阻断方式的临床研究  

Clinical study on impact of blocking mode on transmission of hepatitis B virus infections from mother to infant

作　　者：晋阳秋[1] 李桂英[1] 张彦波[2] 

机构地区：[1]聊城市人民医院生殖遗传科,山东聊城252000 [2]聊城市人民医院胃肠外科,山东聊城252000

出　　处：《中华医院感染学杂志》2014年第13期3338-3340,共3页Chinese Journal of Nosocomiology

基　　金：山东省卫生厅规划基金资助项目(SW-2010B-096)

摘　　要：目的研究采取阻断方式对乙型肝炎病毒(HBV)感染孕妇母婴传播的影响,以期寻找阻断HBV母婴传播的最佳方法,以降低新生儿HBV感染率。方法选择医院2012年6月-2013年6月168例HBV感染孕妇进行研究,根据分娩方式将孕产妇分为两组,A组为剖宫产组76例,B组为阴道分娩组92例,所有新生儿均于出生后24h、1、6个月进行免疫注射,对新生儿出生时与6个月后进行HBsAg阳性率观察;数据采用SPSS 13.0统计处理。结果剖宫产组与阴道分娩组新生儿出生时与6个月后HBsAg阳性率分别为10.53%、13.04%和10.53%、14.13%,不同分娩方法比较差异无统计学意义;HBV-DNA阳性组49例与阴性组119例新生儿出生时和6个月后HBsAg阳性率分别为28.57%、5.04%和30.61%、5.04%;两组比较差异有统计学意义(P<0.05);常规注射乙型肝炎免疫球蛋白孕妇所生产97例新生儿DNA为(3.34±0.68)copies/ml,未注射的71例孕妇所产新生儿DNA为(5.03±1.78)copies/ml,未注射组DNA拷贝数明显高于注射组,两组比较差异有统计学意义(P<0.05)。结论乙型肝炎免疫球蛋白分娩前注射可降低新生儿HBV感染率。OBJECTIVE To study the impact of blocking mode on the transmission of hepatitis B virus （HBV） infec- tions from mother to infant so as to find out the optimal way to block the transmission of HBV and reduce the inci- dence of HBV infections in neonates. METHODS A total of 168 pregnant women with HBV infections who were treated in the hospital from Jun 2012 to Jun 2013 were enrolled in the study and divided into two groups according to the delivery method, the 76 pregnant women in the group A received the cesarean section, and the 92 pregnant women in the group B adopted the vaginal delivery, all the neonates were given the immunization at 24 hours, 1 month, and 6 months after the birth, the positive rate of HBsAg of the neonates was observed at the birth and 6 months after the birth, and the data were statistically analyzed with the use of SPSS13.0 software. RESULTS The positive rate of HBsAg of the neonates at the birth was 10. 53% in the cesarean section group, 10. 53% in the vaginal delivery group; the positive rate of HBsAg of the neonates at 6 months after the birth was 13.04% in the cesarean section group, 14.13~ in the vaginal delivery group; there was no significant difference between the delivery approaches. The positive rate of HBsAg at the birth of neonates was 28.57% in the 49 pregnant women with positive HBV-DNA, 5.04% in the 119 pregnant women with negative HBV-DNA; the positive rate of HB- sAg at 6 months after the birth was 30.61% in the 49 pregnant women with positive HBV-DNA, 5.04% in the 119 pregnant women with negative HBV-DNA; there was significant difference between the two groups （P〈 0.05）. The DNA copy number of the pregnant women who received routine injection of hepatitis B immunoglobu- lin and gave birth to 97 neonates was （3. 34±0.68）copies/ml, significantly lower than （5.03±1.78）copies/ml of the 71 pregnant women who did not, and there was significant difference （P〈0. 05）. CONCLUSION The predelivery injection of hepatitis B immunoglobulin may reduce the incid

关 键 词：乙型肝炎病毒 感染 孕妇 阻断方式 母婴传播 

分 类 号：R512.62[医药卫生—内科学]