联合免疫后乙型肝炎病毒感染母婴传播相关因素的临床研究  

Related factors for mother to child transmission of hepatitis B virus infections after combined immunization

作　　者：李庆彦[1] 李庆方[1] 刘春华[1] 李爱华[2] 晋阳秋[2] 

机构地区：[1]聊城市人民医院肝病科,山东聊城252000 [2]聊城市人民医院妇产科,山东聊城252000

出　　处：《中华医院感染学杂志》2016年第2期424-426,共3页Chinese Journal of Nosocomiology

基　　金：山东省医学科研基金资助项目(102)

摘　　要：目的探讨联合免疫后乙型肝炎病毒感染母婴传播的相关因素,为临床降低母婴乙型肝炎病毒之间传播提供参考依据。方法选取医院2012年6月-2015年6月联合免疫治疗的200例乙型肝炎病毒携带孕妇为研究对象,依据新生儿是否感染乙型肝炎病毒分为感染组18例与未感染组182例,并在新生儿娩出24h内和第4周注射乙型肝炎免疫球蛋白,分析乙型肝炎病毒在母婴之间传播的相关因素。结果 200例孕妇产后新生儿两个月的检查分析,182例新生儿获得免疫成功,免疫成功率91.0%;感染组与未感染组在孕妇血清HBV-DNA阳性和HBeAg阳性以及喂养方式方面比较差异有统计学意义(P<0.05);分娩方式、分娩次数、出生体质量、新生儿性别和早产等因素比较差异无统计学意义;孕妇血清HBV-DNA阳性和HBeAg阳性均是母婴乙型肝炎病毒传播的危险因素(OR=1.093,P=0.004;OR=2.722,P=0.003)。结论母体中乙型肝炎病毒DNA和HBeAg阳性是乙型肝炎病毒感染母婴传播的危险因素,而联合免疫可以减少母婴垂直传播,并可提高新生儿的乙型肝炎病毒免疫成功率。OBJECTIVE To explore the related factors for mother to child transmission of hepatitis B virus（HBV）infections after combined immunization so as to provide guidance for reduction of incidence of the mother to child transmission.METHODS A total of 200 pregnant women carrying with HBV who received the combined immunotherapy from Jun 2012 to Jun 2015 were recruited as the study objects and divided into the infection group with 18 cases and the non-infection group with 182 cases according to the status of HBV infections in neonates.The neonates were injected with the hepatitis B immune globulin within 24 hours after the birth and on Week 14 after the birth;the related factors for the mother to child transmission of HBV were observed.RESULTS The examination analysis of the neonates showed that 182 neonates were successfully immunized after the 200 pregnant women gave birth for 2months,with the success rate of 91.0%.There was significant difference in the positive serum HBVDNA or HBeAg of the pregnant women or the feeding pattern between the infection group and the non-infection group（P〈0.05）.There was no significant difference in the delivery mode,delivery times,birth weight,genders of neonate,or premature delivery.The positive serum HBV-DNA and positive HBeAg of the pregnant women were the risk factors for the mother to child transmission of HBV（OR=1.093,P=0.004;OR=2.722,P=0.003）.CONCLUSION The positive serum HBV-DNA and positive HBeAg of the pregnant women are the risk factors for the mother to child transmission of HBV infections,and the combined immunization can reduce the incidence of vertical transmission and raise the success rate of HBV immunization of the neonates.

关 键 词：联合免疫 乙型肝炎病毒 感染 母婴传播 危险因素 

分 类 号：R512.62[医药卫生—内科学]