孕妇及婴儿联合免疫阻断乙型肝炎病毒宫内传播的临床研究  

Clinical study of interrupting HBV intrauterine infection by immunization of pregnant women and infant

作　　者：韩国荣[1] 余敏敏[1] 沈玲[1] 唐引荣[1] 唐讯[1] 吴岷岷[1] 张小燕[1] 

机构地区：[1]东南大学附属南京第二医院妇产科,南京210003

出　　处：《中华围产医学杂志》2004年第1期8-10,共3页Chinese Journal of Perinatal Medicine

摘　　要：目的　探讨母婴联合免疫阻断乙型肝炎病毒宫内传播的效果。　方法　将 2 16例乙肝表面抗原阳性孕妇分组 ,母婴联合组 12 6例 ,孕妇自孕 2 8周起注射人乙型肝炎免疫球蛋白 (HBIG)2 0 0IU ,新生儿于 0、15d各注射HBIG 2 0 0IU ,然后于 1、2、7月龄各接种基因乙肝疫苗 (HBVac )2 0 μg。对照组 90例 ,只对新生儿进行免疫。母儿血清检测采用美国Abbott酶联免疫试剂测定 ,随访1年。　结果　联合免疫组婴儿宫内感染率低于对照 ( 19.5 1%与 35 .5 6 % ) ,慢性HBV感染率由13.33%降为 3.97% ,P均 <0 .0 5 ;联合免疫组及对照组新生儿出生时抗HBs检出率 ( 80 .95 %与 0 )及 1岁时保护性抗体产生率 ( 96 .0 3%与 86 .6 7% )均明显高于对照组 ,P均 <0 .0 5。　结论　孕妇及婴儿联合免疫可有效预防宫内感染且明显提高宫内感染阻断效果 。Objective To study the efficacy of immunization combination of pregnant women and infants in preventing intrauterine HBV infection. Methods One hundred and twenty six HBsAg positive pregnant women were divided into two groups randomly.In the combination group,126 cases were injected with hepatitis B immunoglobulin(HBIG) during pregnancy since the 28 th week of gestation and HBVac 20 μg at 1、2、7 month combining HBIG 200 IU at 0、15 day was injected to their infants, while 90 cases pregnant women in control group were not injected with HBIG. The serum HBV IgM of pregnant women and infant were tested using ELISA and was followed up for one year. Results The incidence of intrauterine HBV infection and the rate of chronic HBV infection in the infants of combination group were significantly lower than that of the control group (19.51% vs 35.56%, 13.33% vs 3.97% respectively). The detection rate of anti HBs in newborns and protective anti HBs in 1 year were significantly higher in combination group than that in the control group (80.95% vs 0,96.03% vs 86.67%). Conclusion Combining therapy of pregnant women and infant may prevent intrauterine HBV infection effictively and increase the rate of success immunoprophylaxis significantly, and decrease the rate of chronic HBsAg infection.

关 键 词：孕妇 婴儿 联合免疫 乙型肝炎病毒 宫内传播 临床研究 免疫球蛋白 

分 类 号：R714.7[医药卫生—妇产科学]