170例HBsAg阳性孕妇所生新生儿乙肝免疫阻断及感染分析  

Analysis of hepatitis B immune blocking and infection of newborns in 170 cases of HBsAg positive pregnant women

作　　者：王佩琼 陈弘星 

机构地区：[1]陕西省宝鸡市凤翔县医院保健科,陕西宝鸡721400

出　　处：《临床医学研究与实践》2017年第6期133-134,共2页Clinical Research and Practice

摘　　要：目的探讨HBsAg阳性孕妇所生新生儿乙肝免疫阻断及感染情况,为母婴阻断提供依据。方法抽取于我院生产的HBsAg阳性孕妇共170例,将接受被动免疫(HBlg)的72例孕妇作为观察组,未接受HBlg的98例孕妇作为对照组。观察组自孕21周始,每4周注射1次乙肝免疫球蛋白,200 IU/次,直到分娩。两组新生儿在出生24 h采集脐静脉血进行乙肝血清标志物及HBV定量测定。结果观察组新生儿出生24 h HBsAg阳性率、表面抗体保护率均优于对照组,差异有统计学差异(P<0.05);母乳喂养的93例新生儿中无HBsAg阳性,但HBs Ab阳性率明显高于人工喂养,差异有统计学意义(P<0.05)。结论母亲HBsAg阳性的新生儿HBsAg阳性率较高,但孕期接受HBlg可大大降低新生儿HBsAg阳性率,增加HBs Ab抗体保护率。HBsAg阳性母亲的儿童采取乙肝疫苗联合乙肝免疫球蛋白预防接种进行传播阻断,其阻断成功率相对较高。Objective To investigate B immune blocking and infection of newborns in 170 cases of HBsAg positive pregnant women, and to provide evidence for maternal and infant block. Methods A total of 170 HBsAg positive pregnant women in our hospital were selected, of which 72 cases received passive immunization（HBlg） were selected as the observation group, 98 cases did not receive HBlg were selected as the control group. The observation group had injection of hepatitis B immune globulin every 4 weeks since 21 weeks before pregnancy, 200 IU/time until delivery. The hepatitis B serum markers and quantitative determination of HBV of newborns in the 24 h after birth in the two groups were detected by collecting umbilical vein blood. Results The positive rate of HBsAg and the protective rate of surface antibody of newborns in 24 h after birth in the observation group were better than those in the control group（P〈0.05）; there was no HBsAg positive cases in 93 newborns who had breastfeeding, but their positive rate of HBs Ab was significantly higher than that of artificial feeding（P〈0.05）. Conclusion The HBsAg positive rate of newborns in HBsAg positive mother is higher,but for pregnant women, receiving HBlg during pregnancy can greatly decrease the positive rate of HBsAg of newborns, and increase the protection rate of HBs Ab antibody. Children who have HBsAg positive mothers can have hepatitis B vaccine combined with hepatitis B immunoglobulin vaccination to block the transmission, and the blocking success rate is relatively high.

关 键 词：母亲HBsAg阳性 新生儿 乙肝免疫阻断 

分 类 号：R714.25[医药卫生—妇产科学]