乙型肝炎病毒感染免疫预防母婴传播的效果评估  

Evaluation on effect of immunization on mother to child transmission of hepatitis B virus infections

作　　者：丁霄雁 耿慧[1] 段彼得[1] 马爱荣[1] 

机构地区：[1]淄博市中心医院产科,山东淄博255036

出　　处：《中华医院感染学杂志》2015年第7期1657-1659,共3页Chinese Journal of Nosocomiology

基　　金：山东省科技厅研究基金资助项目(20120657CH)

摘　　要：目的针对乙型肝炎e抗原(HBeAg)阴性乙型肝炎病毒(HBV)感染母亲,母婴传播应用乙型肝炎疫苗联合乙型肝炎免疫球蛋白常规免疫预防的临床疗效,并观察分娩与喂养方式对乙型肝炎病毒母婴传播的影响,为临床治疗提供参考依据。方法随机选取医院乙型肝炎表面抗原(HBsAg)阳性产妇899名,到院参与的母亲230名,儿童250名,检测其乙型肝炎血清学标志物及丙氨酸氨基转移酶,采用SPSS 17.0软件进行统计分析。结果230名母亲注射与未注射乙型肝炎疫苗或乙型肝炎免疫球蛋白的儿童均无乙型肝炎病毒感染,抗-HBs阳性率为65.63%、78.29%;250名儿童中母亲行剖宫产与自然分娩均无乙型肝炎病毒感染,而抗-HBs阳性率77.14%、72.41%,差异无统计学意义;3种不同喂养方式的儿童均无乙型肝炎病毒感染,抗-HBs阳性率比较差异也无统计学意义。结论 HBsAg阳性但HBeAg阴性的产妇婴儿经免疫预防后几乎无乙型肝炎病毒感染情况,产妇孕晚期使用HBIG,分娩及喂养方式对乙型肝炎病毒母婴传播和新生儿对乙型肝炎疫苗的抗体无关联。OBJECTIVE To evaluate the clinical efficacy of routine immunization of hepatitis B vaccine combined with hepatitis B immunoglobulin（HBIG）for prevention of mother to child transmission in mothers with of HBeAg-negative hepatitis B virus（HBV）infections and observe the effects of childbirth and feeding patterns on mother to child transmission of HBV,so as to provide reference for clinical treatment.METHODS Totally 899 pregnant women were randomly selected who were HBsAg positive.Among them,230 mothers and 250 children participated in hospital visits for follow infup and they were tested for serum indicators of hepatitis B and alanine aminotransferase.The software SPSS17.0was used for statistical analysis.RESULTSIn the 230 mothers or children injected and un-injected with hepatitis B vaccine and hepatitis B immune globulin,no HBV infection occurred and the anti-HBs positive rate was 65.63%,78.29%.In the 250 children who were born through cesarean section or natural childbirth,no HBV infection occurred and the anti-HBs positive rate was 77.14%,72.41%,with no statistical significance.In children with three different feeding patterns,no HBV infection occurred and the difference in the anti-HBs positive rate was not significant.CONCLUSIONChildren of HBsAg-positive but HBeAg-negative mothers almost had no HBV infection after immunization.Use of HBIG in late-gestation,childbirth and feeding patterns were not associated with mother to child transmission of HBV and newborn antibodies to hepatitis B vaccine.

关 键 词：乙型肝炎病毒 乙型肝炎疫苗 乙型肝炎免疫球蛋白 母婴传播 

分 类 号：R512.64[医药卫生—内科学]