探讨免疫预防乙型肝炎病毒母婴传播的效果及影响因素  

Effect of immunization on prevention of mother to infant transmission of hepatitis B virus and influencing factors

作　　者：黄敏[1] 周海新[2] 郑粼 HUANG Min;ZHOU Hai-xin;ZHENG Lin(Haikou Municipal Center for Disease Control and Prevention,Haihou,Hainan 570102,China)

机构地区：[1]海口市疾病预防控制中心综合门诊,海南海口570102 [2]海南省中医院胃肠镜室,海南海口570203

出　　处：《中华医院感染学杂志》2018年第17期2670-2672,2676,共4页Chinese Journal of Nosocomiology

基　　金：海南省卫生计生行业科研基金资助项目(14A210219)

摘　　要：目的探讨免疫预防阻断乙型肝炎病毒母婴传播的效果及影响因素。方法选取2014年4月-2017年1月来疾控中心门诊注射疫苗母亲为HBsAg阳性的新生儿,共计101例,在新生儿8~12月龄时检测HBV血清标志物。结果随访101例HBsAg阳性母亲所产新生儿,发现HBsAg阳性8例,免疫阻断失败率为7.92%;HBsAb阳性61例,HbsAb阳性率为60.40%;HBeAg阳性孕妇免疫阻断失败率为15.38%,高于HBeAg阴性孕妇(χ2=6.213,P=0.013);HBV DNA阳性孕妇免疫阻断失败率为10.39%,高于HBV DNA阴性孕妇(χ2=4.041,P=0.044);新生儿仅疫苗预防的免疫阻断失败率为23.33%,高于免疫方式为疫苗+HBIG的新生儿(χ2=11.056,P=0.001);多因素Logistic回归分析结果显示,孕妇HBeAg状态、新生儿免疫方式是免疫阻断失败的独立影响因素(OR=1.988,1.706;P=0.002,0.004)。结论免疫预防乙型肝炎病毒母婴传播的效果较好,其中孕妇HBeAg状态及新生儿免疫方式对免疫阻断效果有一定影响。OBJECTIVE To explore the effect of immunization on prevention of mother to infant transmission of hepatitis B virus（HBV）and investigate the influencing factors.METHODS A total of 101 neonates whose mothers were positive for HBsAg and vaccinated in outpatient departments of the center for disease control and prevention from Apr 2014 to Jan 2017 were enrolled in the study,and the serum markers of HBV of the neonates were detected at the age of 8-12 months.RESULTS The result of a follow-up showed that of the 101 neonates whose mothers were positive for HBsAg,8 were positive for HBsAg,and the rate of failure of immune block was 7.92%;61 were positive for HBsAb,with the positive rate of HBsAb 60.40%.The rate of failure of immune block of the HBeAg-positive pregnant women was 15.38%,significantly higher than that of the HBeAg-negative pregnant women（χ^2=6.213,P=0.013）.The rate of failure of immune block of the HBV DNA-positive pregnant women was 10.39%,significantly higher than that of the HBV DNA-negative pregnant women（χ^2=4.041,P=0.044）.The rate of failure of immune block of the neonates who were only vaccinated for prevention was 23.33%,significantly higher than that of the neonates who had vaccination plus HBIG（χ^2=11.056,P=0.001）.The result of multivariate logistic regression analysis showed that the status of HBeAg of pregnant women and immunization modes were the independent influencing factors for the failure of immune block（OR=1.988,1.706;P=0.002,0.004）.CONCLUSIONThe immunization may achieve remarkable effect on prevention of mother to infant transmission of HBV;the status of HBeAg of pregnant women and immunization mode have certain impact on the immune block.

关 键 词：乙型肝炎病毒 疫苗 乙型肝炎免疫球蛋白 母婴传播 

分 类 号：R174[医药卫生—妇幼卫生保健]