HBsAg阳性孕妇及其新生儿用HBIG对乙型肝炎病毒母婴传播的阻断效果观察  

Study on the blocking effect of injecting HBsAg positive mothers during pregnancy and their infants at birth with HB immunoglobulin on mother-to-infant transmission of HBV

作　　者：刘一萍[1] 邵中军[1] 徐德忠[1] 门可[1] 徐剑秋 闫永平[1] 

机构地区：[1]第四军医大学流行病学教研室,陕西西安710033 [2]陕西省妇幼保健医院,陕西西安710003

出　　处：《疾病控制杂志》2004年第2期109-111,共3页Chinese Journal of Disease Control and Prevention

基　　金：国家自然科学基金资助项目 (39970 6 5 2 );国家自然科学基金资助重点课题 (30 2 30 32 0)

摘　　要：目的　探讨乙型肝炎 (乙肝 )表面抗原 (HBs Ag)阳性母亲产前用乙肝免疫球蛋白 (HBIG)及其婴儿 HBIG联合乙型肝炎疫苗阻断母婴传播的效果。方法　对 2 4 3名 HBs Ag阳性孕妇孕晚期每月注射 HBIG 2 0 0 IU ,新生儿出生后采股静脉血 ,同时在出生后 2 4 h内注射 HBIG 2 0 0 IU ,然后在 0、1、6月龄接种基因重组型乙肝疫苗 ,每次 5μg。并和 4 0 2例产前未注射 HBIG的 HBs Ag阳性孕妇比较 ,其所生新生儿在 0、1、6 (30 μg、10 μg、10 μg)月龄只用血源型乙肝疫苗免疫 ;两组婴儿都分别在 1、3、6、12、2 4月龄静脉采血 ,用酶联免疫吸附试验 (EL ISA)检测 HBV标志物 ,同时随访。结果　孕妇注射 HBIG组的宫内感染率为 2 .4 7% ,低于未注射 HBIG组 3.73% ,差异无显著性(χ2 =0 .77,P >0 .0 5 )。产前用 HBIG和新生儿 HBIG联合疫苗组没有发生慢性 HBV感染的婴儿 ,而未注射 HBIG孕妇所生的 4 0 2例婴儿中 ,有 9例婴儿发生慢性 HBV感染 ,其母亲都是 HBs Ag和乙肝 e抗原 (HBe Ag)均阳性 ,主要是宫内感染。结论　产前用 HBIG和新生儿 HBIG联合免疫可降低慢性 HBV感染率 ,阻断宫内感染的慢性化 。Objective To study the effect of HB immunoglobulin (HBIG) on HBsAg positive mothers during the third trimester of pregnancy and combined use of HBIG and HB vaccine to infants on the blocking of vertical transmission of HBV and the status of hepatitis B resulting from mother-to-infant transmission. Methods A total of 645 HBsAg positive mothers were divided into two groups, group 1 without HBIG and their infants with three doses of plasma-derived vaccine given at 0, 1 and 6 months; group 2 with HBIG200IU respectively during the third trimester of pregnancy and their infants with HBIG200IU at birth and three 5 μg doses of recombinant vaccine given at 0, 1 and 6 months. All infants were followed up for the hepatitis B detection at the age of 1, 3, 6, 12, 24 months by enzyme-linked immunoadsorbent assay (ELISA). Results 9 infants which were infected chronically with HBV were all in group 1, among them 8 were HBsAg positive before the age of 6 months mainly attributing to intrauterine infection. No infants were infected chronically by HBV in group 2. The chronical infection rate of HBV of infants in group 1 was significantly higher than that in group 2, ( χ 2=4.008, P<0.05). Conclusions Use of HB immunoglobulin (HBIG) to HBsAg positive mothers during the third trimester of pregnancy and combined use of HBIG and HB vaccine to infants could block the chronicity of HB resulting from intrauterine infection.

关 键 词：HBSAG阳性 孕妇 新生儿 HBIG 乙型肝炎 母婴传播 乙肝免疫球蛋白 乙肝表面抗原 

分 类 号：R512.62[医药卫生—内科学]