GAVI项目四川省孕产妇乙型肝炎病毒表面抗原筛查及母婴阻断效果分析  

Effects of HBs Ag Screening in Pregnant Women and Prevention of Mother-to-child Transmission in Sichuan Province in the GAVI Program

作　　者：张佩如[1] 胡新[1] 杜飞[1] 刘宇[1] 漆琪[1] 刘家洁[1] 赵家俊[1] 李银乔[1] 陈筱纯[1] 王进[1] 马千里[1] 郑红茹[1] 敬嵛淋[1] 刘力铭[1] ZHANG Peiru HU Xin DU Fei LIU Yu QI Qi LIU Jiajie ZHAO Jiajun LI Yinqiao CHEN Xiaochun WANG Jin MA Qianli ZHEN Hongru JING Yulin LIU Limin(Sichuan Center for Disease Prevention and Control, Chengdu 610041, Sichuan Province, China.)

机构地区：[1]四川省疾病预防控制中心,成都610041

出　　处：《预防医学情报杂志》2017年第4期343-347,共5页Journal of Preventive Medicine Information

摘　　要：目的了解产妇乙肝标志物筛查情况及乙肝病毒(HBV)母婴阻断工作开展现状,评价乙型肝炎病毒表面抗原(HBs Ag)阳性产妇筛查及新生儿母婴阻断措施开展情况。方法在四川省彭州市和西充县选取2013-01-01/2014-03-31期间在医院产前筛查出的乙肝病毒表面抗原(HBs Ag)阳性住院分娩产妇及新生儿作为调查对象,开展流行病学调查。结果调查地区医疗机构产妇HBV血清学标志物筛查均采用国产酶联免疫吸附试验(ELISA)试剂,产妇HBs Ag阳性筛查率为5.18%,新生儿乙肝疫苗首针及时率为99.72%。随访的330名HBs Ag阳性产妇的新生儿均开展乙肝免疫球蛋白(HBIG)联合乙肝疫苗(Hep B)免疫策略,89.79%的新生儿接种10μg重组Hep B(酵母)。新生儿HBs Ag阳性率2.1%,乙肝病毒表面抗体(Anti-HBs)阳性率93.09%。不同喂养方式(χ~2=8.210,P=0.004)和母亲乙肝病毒e抗原(HBe Ag)产前不同检测结果(χ~2=4.500,P=0.034)对新生儿HBs Ag阳性率差异有统计学意义。结论调查地区HBV垂直传播母婴阻断措施实施效果显著,且不受喂养方式和分娩方式的影响,HBs Ag和HBe Ag双阳性和HBV DNA水平较高(>106 U/ml)孕妇应为母婴阻断的重点人群。Objective To evaluate the effects of Hepatitis B Virus surface antigen （HBsAg） screening in pregnant women and prevention of mother - to - child transmission in new born babies. Methods The epidemiological investigation was conducted during the period from January 1, 2013 to March 31, 2014, with pregnant women who were screened for HBsAg positive in prenatal examinations and their newborns in Pengzhou City and Xi- chong County in Sichuan Province as the subjects, to obtain the screening results for maternal hepatitis B virus （HBV） serologic markers and the implementation of HBV mother -to -child prevention, the follow -up results of HBsAg positive pregnant women and their newborns, and the evaluation results of prevention strategy in HBV -positive pregnant women. Results Domestic enzyme -linked immunosorbent assay （ELISA） kits were used for pregnant women HBsAg screening in hospitals of the investigation areas. The HBsAg positive screening rate of pregnant women was 5.18% , and the newborns＇ timely first dose rate of hepatitis B vaccine was 99.72%. Newborns of 330 HBsAg positive mothers had accepted combined Hepatitis B Immunoglobulin （HBIG） with HepB vaccination, and 89.79% infants had been vaccinated with 10lxg HepB. The rate of HBsAg positive newborns was 2. 1%, and the positive rate of antibody to HBsAg （ Anti - HBs） was 93.09%. There were statistical differences between the HBsAg positive rates of newborns on different feeding ways （X2 = 8.210, P = 0. 004） and of mothers with different prenatal examination results of HBeAg （X2 =4. 500, P = 0. 034）. Conclusion The HBV mother- to -child transmission prevention strategy has yielded remarkable effects in the investigation areas, which were not affected by the delivery and feeding patterns. Pregnant women with positive HBsAg and HBeAg and the high levels of HBV DNA （ 〉 106 U/ml） are a key population for the prevention of mother - to - child transmission.

关 键 词：乙型肝炎病毒 母婴传播 乙型肝炎疫苗 乙型肝炎免疫球蛋白 预防接种 

分 类 号：R512.62[医药卫生—内科学]