HBV孕妇注射乙肝免疫球蛋白阻断HBV母婴垂直传播的被动免疫机制  

Mechanism of passive immunity of blocking of HBV mother-infant vertical transmission by injection of HBV immunoglobulin among pregnant women with HBV infection

作　　者：刘淑媛[1] 杜敬佩[1] 祝金冉 郜媛[1] 李汝珂 赵巍峰[1] 

机构地区：[1]新乡医学院第三附属医院,河南新乡453003

出　　处：《中国妇幼保健》2015年第21期3570-3572,共3页Maternal and Child Health Care of China

基　　金：河南省卫生厅卫生政策研究课题〔YWZY2011021〕

摘　　要：目的探讨HBV阳性孕妇注射乙肝免疫球蛋白阻断HBV母婴垂直传播的被动免疫机制。方法选取2013年1月-2014年1月该院收治的乙型表面抗原（HBsAg）阳性孕妇100例，随机分为观察组和对照组，每组各50例。观察组在孕28、32、36周肌肉注射乙肝免疫球蛋白3次，200IU／次；对照组仅随访查体未予以药物。应用双抗夹心酶联免疫吸附法（DAS—ELISA）检测母婴血清乙肝标志物及细胞因子IL-6、IL-12、IFN-γ水平，应用荧光定量PCR（FQ-PCR）技术检测HBVDNA含量。结果治疗后，观察组血清中HBVDNA含量显著低于对照组，差异有统计学意义（P〈0．05）；观察组孕妇的IL-12、IFN-r水平显著高于对照组，IL-6水平显著低于对照组，差异均有统计学意义（P均〈0．05）；观察组、对照组的新生儿脐血清抗-HBs检出率分别为64．0％、4．0％，观察组、对照组的新生儿宫内感染率分别为4．0％、20．0％，差异均有统计学意义（P均〈0．05）。结论HBV阳性孕妇注射乙肝免疫球蛋白可有效阻断HBV母婴垂直传播，与胎盘转运IgG型抗体及乙肝免疫球蛋白对机体感染HBV引发的免疫缺陷调节作用密切相关。Objective To explore the mechanism of passive immunity of blocking of hepatitis B virus （ HBV ） mother - infantvertical transmission by injection of HBV immunoglobulin among pregnant women with HBV infection. Methods One hundred pregnant women with positive HBsAg were selected from the hospital from January 2013 to January 2014, then they were randomly divided into obser- vation group and control group, 50 cases in each group. The cases in observation group were treated with intramuscular injection of HBV im- munoglobulin for three times （28, 32, 36 gestational weeks）, 200 IU per time; the cases in control group only received physical examination without drug therapy. Sandwich ELISA was used to detect the levels of serum HBV markers, interleukin-6 （IL-6）, interleukin-12 （IL- l2）, and interferon-γ （IFN-γ） . Fluorogenic quantitative PCR was used to detect HBV DNA load. Results After treatment, serum HBV DNA content in observation group was statistically significantly lower than that in control group （P〈0. 05 ） ; the levels of IL-12 and IFN-,/in observation group were statistically significantly higher than those in control group （P〈0. 05）, the level of IL-6 was statistically significantly lower than that in control group （ P〈0.05 ） ; the detection rates of umbilical cord serum anti-HBs in observation group and control group were 64.0% and 4. 0%, respectively, there was statistically significant difference between the two groups （ P〈0. 05 ） ; the incidence rates of intra- uterine infection in observation group and control group were 4. 0% and 20. 0%, respectively, there was statistically significant difference be- tween the two groups （P〈0. 05） . Conclusion Injection of HBV immunoglobulin among pregnant women with HBV infection can effective- ly block HBV mother-infant vertical transmission; placental transfer IgG antibody and HBV immunoglobulin are closely related to regulating effect of immunodefieiencv caused by HBV infection.

关 键 词：临床研究 免疫球蛋白 垂直传播 乙肝 

分 类 号：R373.21[医药卫生—病原生物学]