A randomized control trial on interruption of HBV transmission in uterus

Objective To study the interruptive effect of hepatitis B virus (HBV) specific immunolobulin (HBIG) before delivery in attempt to prevent intrauterine transmission of HBV.Methods Nine hundred and eighty HBsAg carrier pregnant women were randomly divided into HBIG group and control group. Each subject in the HBIG group received 200 IU or 400 IU of HBIG intramuscularly at 3, 2 and 1 month before delivery. The subjects in the control group did not receive any specific treatment. All newborn infants received 100 IU of HBIG intramascularty after venous blood samples were taken at birth and 2 weeks after birth, followed by 30 μg plasma-derived HB vaccine or 5 μg recombinant yeast-derived hepatitis B vaccine at 1, 2 and 7 months of age. Blood tests were performed for all the lying-in women and their neonates. Blood specimens were tested for HBsAg and HBeAg by enzyme immunoassay. All infants were followed up for 1 year.Results In the HBIG group, 491 neonates were born to 487 HBV carrier mothers; and in the control group, 496 neonates were born to 493 HBV carrier mothers. The rates of intrauterine transmission in the two groups were 14.3% and 5.7% respectively (χ2=20.280, P<0.001), and the rates of chronic hepatitis B in the two groups were 2.2% and 7.3% respectively (χ2=13.696, P<0.001). The high risk factors of intrauterine HBV infection included HBsAg HBeAg double positive and HBV DNA positive in the peripheral blood of pregnant women.Conclusion HBV infection in the uterus may be interrupted by injecting multiple intramuscular HBIG injections before delivery without causing any side-effects.     

乙肝表面抗原阳性孕妇肌肉注射乙肝免疫球蛋白预防母婴传播的临床分析

目的 探讨经母亲对胎儿行被动免疫在预防乙型肝炎病毒(HBV)宫内感染中的作用.方法 对自孕20周起多次肌肉注射乙肝免疫球蛋白(HBIG)的乙肝表面抗原(HBsAg)(+)孕妇68例(A组)及未注射的28例HBsAg(+)孕妇(B组)采用固相放免法和套式PCR检测母血HBsAg、HBV DNA及其新生儿血HBsAg、抗HBS、HBV DNA.结果 A组70例新生儿中64例血清抗HBS(+),与B组相比差异有统计学意义(P＜0.05).A组新生儿血HBsAg、HBV DNA检出率均明显低于B组.A组孕妇用药后血HBsAg滴度及HBVDNA水平较用药前明显下降.结论 经母亲对胎儿行被动免疫可有效预防HBV宫内感染. Abstract： Objective To investigate the effect of passive immunization of fetus by infection of mother with HBIG on drevention of HBV intrauterine infection. Methods Forty-eight pregnant women with HBsAg positive were divided into two groups:group A(68 cases)were injected with HBIG during pregnancy;group B(28 cases)were followed up without injecfion of HBIG as controls. The blood samples of mothers and their infants were tested with radioimmunoassay and PCR. Results of 70 infants in group A,64(91.46%)were positive for anti-HBs(P＜0.05).The infants with HbsAg positive and HBV DNA positive in group A were fewer than those in group B(P=0.02 and ＜0.05). Conclusions Passive immunization of fetus by iniection to mother with HBsAg may prevent HBV intrauterine infection effectively.     

Positive Rate of Different Hepatitis B Virus Serological Markers in Peking Union Medical College Hospital,a General Tertiary Hospital in Beijing△

Objectives To investigate the positive rate of different hepatitis B virus (HBV) serological markers, and the demographic factors related to HBV infection.
Methods We enrolled all patients tested for HBV serological markers, such as HBV surface antigen (HBsAg), HBV surface antibody (HBsAb), hepatitis B e antigen (HBeAg), hepatitis B e antibody (HBeAb), HBV core antibody (HBcAb), and HBV-DNA from July 2008 to July 2009 in Peking Union Medical College Hospital. The positive rate of each HBV serological marker was calculated according to gender, age, and de- partment, respectively. The positive rates of HBV-DNA among patients with positive HBsAg were also analyzed.
Results Among 27 409 samples included, 2681 (9.8%) were HBsAg positive. When patients were divided into 9 age groups, the age-specific positive rate of HBsAg was 1.2%, 9.6%, 12.3%, 10.9%, 10.3%, 9.7%, 8.0%, 5.8%, and 4.3%, respectively. The positive rate of HBsAg in non-surgical department, surgical department, and health examination center was 16.2%,5.8%,and 4.7%, respectively. The positive rate of HBsAg of males (13.3%) was higher than that of females (7.3%,P=0.000). Among the 2681 HBsAg (+) patients, 1230 (45.9%) had HBV-DNA test, of whom 564 (45.9%) were positive. Patients with HBsAg (+), HBeAg (+), and HBcAg (+) result usually had high positive rate of HBV-DNA results (71.8%,P=0.000).
Conclusions Among this group of patients in our hospital, the positive rate of HBsAg was relatively high. Age group of 20-29, males, and patients in non-surgical departments were factors associated with high positive rate of HBsAg.     

A pilot study on the combined therapy of granulocyte-macrophage colony-stimulating factor and hepatitis B vaccine on chronic hepatitis B virus carrier children

Objective To observe the efficacy of treating intrauterine infected chronic hepatitis B virus (HBV) carrier children with a combination of granulocyte-macrophage colony-stimulating factor (GM-CSF) or hepatitis B immunoglobulin (HBIG) plus recombinant hepatitis B vaccine (rHBvac).Methods A total of 27 chronic HBV infected children, who were born to HBV carrier mothers and received hepatitis B immunoprophylaxis at birth, were randomized into 2 groups: one receiving a combined therapy of 50 μg of GM-CSF plus 10 μg of rHBvac injected intramuscularly at the same location (GM-CSF group, 14 children) or 200 IU HBIG and 10 μg rHBvac in different muscles (HBIG group, 13 children) on a monthly four-dose schedule. HBV-DNA quantification and other HBV serological markers were tested before and after the four-dose therapy. Results Twelve children in each group completed the study. Of them, 3 children in the GM-CSF group and 4 in the HBIG group had elevated serum alanine transaminase (ALT) before the trial, and then 2 in each group became ALT normal after the treatment. Before the therapy, hepatitis B e antigen (HBeAg) positivity was found in nine children in the GM-CSF group and 10 in the HBIG group. One from each group had an HBeAg/anti-HBe seroconversion after the treatment. The quantity of HBV-DNA was significantly lower after the treatment (P=0.023) in GM-CSF group, but was not significantly reduced in HBIG group. No subjects were found to be negative for hepatitis B surface antigen (HBsAg) after the treatment, and no serious adverse events occurred in either group. Conclusion Combined GM-CSF and rHBvac therapy inhibit HBV replication in carrier children who were not protected after treatment with immunoprophylaxis.     

Mechanism of peripheral blood mononuclear cell invasion by HBV on artificial immunization in newborns

Objective To study the effect and mechanism of the peripheral blood mononuclear cell (PBMC) invasion by HBV on artificial immunization in newborns.Methods Fifty- two newborns of HBsAg positive mothers were immunized with HBIG (hepatitis B immunoglobulin) and HBVac (hepatitis B vaccine) and were followed up for 7 months. The newborns’ HBV- DNA in serum and in the PBMCs was detected with nested- PCR; anti- HBs was tested with solid phase radioimmunoassay (SP- RIA). PBMCs isolated from newborn peripheral blood were incubated in the presence of PHA or purified HBsAg. Interleukin- 2 (IL- 2) level in culture supernatants of activated cells was detected by ELISA.Results The failure rate of immunization was higher in infants with positive HBV- DNA in PBMCs than those with negative HBV- DNA (P<0.05); IL- 2 level in PBMC culture supernatants was lower in former than in the latter and in normal controls (P<0.05). The level of IL- 2 in the immunization failure newborns was lower than that in the successfully immunized newborns and in normal controls (P<0.05).Conclusions Intrauterine invasion of PBMCs by HBV is one of the important reasons for immunization failure in newborns. IL- 2 production is closely related to the invasion of PBMCs by HBV, which may contribute to the failure of artificial immunization in newborns.     

Urban-rural comparison of HBV and HCV infection prevalence in eastern China

The present study was initiated to make and urban-rural comparison of the prevalence of cases positive to hepatitis B and C virus(HBV and HCV,respectively)infection markers in densely populated eastern half of China.For this purpose.10 survey sites were selected,i.e.,six sites in urban areas(the city group;Beijing,shangahi and four provincial capitals)and four sites in rural areas(the village group;one village each in Jilin and Shandong provinces,and two villages in Shaanxi Province),About 50 adult women per site volunteered to participate,from whom 494 valid bllod samples were collected.Positivities to HBsAg(HBsAg^ ),anti-HBs(anti-HBs^ )and antiHBc(anti-HBc^ )were examined by RIA methods.and that to anti-HCV(anti-HCV^ )by either EIA or RIA.Those positive to any one of the three HBV infection markers were taken as HBV infection-positive(HBV^ ).The prevalence of HBsAg^ ,HBV^ and anti-HBc^ was 8%,70%and 2.7% in the city group,and 8%,65% and 2.0%in the village group,and no significant difference was found between the two groups.The overall prevalence was 8% for HBsAg^ ,68% for HBV^ ,and 2.4% for anti-HVC^ ,The results were discussed in reference to some 20 papers each on HBV^ and anti-HCV^ prevalence in China published since(1991),The reviewing of these papers of anti-HCV was low(well below 5%),and that no substantial difference was found between the rural and urban populations.     

Relationship between Maternal PBMC HBV cccDNA and HBV Serological Markers and its Effect on HBV Intrauterine Transmission

Objective To investigate the relationship between maternal peripheral blood mononuclear cells (PBMC) hepatitis B virus(HBV) covalenty closed circular deoxyribonucleic acid(cccDNA) and other HBV serological markers and its effects on HBV intrauterine transmission. Methods We enrolled 290 newborns and their hepatitis B surface antigen(HBsAg) positive mothers. HBV cccDNA in PBMC and HBV DNA in serum were detected by a real‐time PCR‐TaqM an probe while HBV serological markers were detected with an electrochemiluminescence immunoassay. Results There was a positive correlation between the levels of PBMC HBV cccD NA and serum HBV DNA and HBeA g(r = 0.436 and 0.403, P 0.001). The detection rate of pattern A [‘HBsA g(+), HBeA g(+), and anti‐HBc(+)'] was significantly higher in the PBMC HBV cccD NA positive group than in the control group(χ2 = 48.48, P 0.001). There was a significant association between HBV intrauterine transmission and PBMC HBV cccD NA(χ2 = 9.28, P = 0.002). In the presence of serum HBV DNA, HBeA g, and PBMC HBV cccD NA, the risk of HBV intrauterine transmission was three times higher(OR = 3.69, 95% CI: 1.30‐10.42) than that observed in their absence. The risk of HBV intrauterine transmission was the greatest(OR = 5.89, 95% CI: 2.35‐14.72) when both PBMC HBV cccD NA and pattern A were present. A Bayesian network model showed that maternal PBMC HBV cccD NA was directly related to HBV intrauterine transmission. Conclusion PBMC HBV cccDNA may be a direct risk factor for HBV intrauterine transmission. Our study suggests that serological markers could be combined with PBMC‐related markers in prenatal testing.     

Relationship between heterogeneity of HBV preS/S gene and intrauterine transmission

Objective: To study the relationship of the mutation of HBV preS/S gene in HBsAg carrying pregnant women and intrauterine transmission. Methods: Polymerase chain reaction (PCR) was used to amplify HBV preS/S gene from sera of 8 HBsAg carrying pregnant women, 4 women's neonates infected with HBV, and the other's neonates non-infected with. The PCR products were cloned and 5 clones were chosen from every woman for DNA sequencing. Results: Heterogeneity of HBV preS/S gene in HBsAg carrying pregnant women having intrauterine transmission was much higher than that from having not intrauterine transmission, and the divergence rate of nucleotide sequences also higher strikingly. Conclusion: High heterogeneity of HBV preS/S gene of HBsAg positive pregnant women may be relative to high rate of intrauterine transmis-     

Comparative assay of Hepatitis B and C virus infection markers by different assay kits

In order to compare sensitivity of EIA and RIA assay kits for hepatitis B and C virus(HBV and HCV,respectively)infection markers,100 serum samples in total wre collected form 50 adult women each in urban and rual areas in northeast China.The number of positive cases to the three infection markers on HBV(i.e..,HBsAg^ ,anti-HBs^ ,and anti-HBc^ )and the one on HVC (anti-HCV)were examined in two laboratories,i.e.,in Laboratory A with EIA kits produced in China and in Laboratory B with RIA kits.HCV infection positivity(anti-HCV^ )was examined by EIA kits in both laboratories,but from diffeent sources in and outside of China,respectively.The assay in Laboratory A gave 2 HBsAg^ cases out of the 100 cases examined,whereas there were 9 positive cases in Labortory B,In contrast,19 cases were positive to anti-HCV when examined in Laborator A,and there were 3 cases in Laboratory B.Thus,the kits used in Laboratory A gave fewer HBsAg^ and more anti-HCV^ cases than the kits used in Laboratory B.The prevlence of antiHBs^ or anti-HBc^ and cases did not differ when assayed in the two laboratories with EIA and RIA kts,respectively,The agreement of positive and negative findings between the two set of testing were 93%,93%,93%,86%and 82% for HBsAg,anti-HBs,anti-HBc,BHV(i.e.,either positive to anyone of the three markers or negative to all three markers),and anti-HCV,respectively.The implication of the observation on epidemiology on HBV and HCV infection prevalence was discussed.     

Five-year follow-up of immune response to hepatitis B vaccine in juveniles.

The persistence of anti-HBs was investigated in 95 juveniles who received plasma-derived HBV vaccine (vaccine group) and 63 counterparts who got anti-HBs from natural HBV infection (infection group) for a period of five years. The positive rates of anti-HBs from the first to fifth year in the vaccine group are 97.89%, 98.95%, 81.05%, 78.95% and 72.63% respectively with one recipient remaining anti-HBs negative after being immunized with three dosages of 10 micrograms plasma-derived HBV vaccine in 0, 1st, 2nd month and the mean S/N values (GMV) are 30.94, 22.18, 13.61, 12.02 and 9.18 respectively. There are 26 recipients whose anti-HBs turned from positive to negative at the end of the study with a negative rate of 27.37%. The S/N GMVs in the infection group are 36.37, 27.33, 24.08 at the first, third and fifth year of the study, respectively. Both the S/N GMV and negative rate are lower than that of the vaccine group (P < 0.01). No one was found to have positive HBsAg or elevated ALT in both groups. Questions such as immune dosage, immune program and booster immunization in juvenile population are discussed.

     

乙肝免疫球蛋白阻断病毒母婴传播的效果观察

目的 :探讨高效价乙肝免疫球蛋白 (HBIG)阻断乙型肝炎病毒 (HBV)母婴传播的作用机理。方法 :将5 0例HBsAg阳性的孕妇随机分成两组 ,实验组 30例 ,分别自孕 2 8周、32周、及 36周肌肉注射HBIG2 0 0IU ,分娩后 2 4h内再注射HBIG 2 0 0IU 1次 ;对照组 2 0例 ,不用HBIG。两组孕妇所生婴儿均于出生后 2 4h内肌肉注射HBIG 10 0IU 1次 ,注射乙肝疫苗的时间和剂量均按正常婴儿的操作方案进行。母儿血清HBsAg ,HBeAg和抗 HBs用固相放免法检测 ,HBV DNA用荧光定量PCR检测。结果 :实验组婴儿血清HBsAg和HBV DNA检出率明显低于对照组 (P <0 .0 5 ) ;实验组婴儿抗 HBs阳性率显著高于对照组 (P <0 .0 5 )。结论 :孕妇于孕期多次注射HBIG进行被动免疫 ,可有效地阻断乙型肝炎病毒母婴传播 ,减少婴儿HBV感染率。     

乙肝疫苗联合乙肝免疫球蛋白阻断乙肝病毒母婴传播的临床效果

目的：探讨乙肝免疫球蛋白（HBIG）和乙肝疫苗联合阻断乙肝病毒（HBV）母婴传播的疗效。方法：选择2014年12月~2015年12月间246例HBsAg阳性孕妇为研究对象,根据随机数字表法分为观察组及对照组,均123例。对照组仅新生儿单独接种乙肝疫苗,观察组孕妇及新生儿均联合接种乙肝疫苗和HBIG。结果：对照组及观察组新生儿中出现宫内HBV感染率分别为22.76%和9.76%,一年后对照组及观察组新生儿中HBV感染率分别16.26%和1.63%,两组间差异均存在统计学意义。对照组及观察组新生儿出生时及一年后对应HBsAb阳性率分别为8.13%、76.42%和27.64%、94.31%,两组差异存在统计学意义。结论：孕妇及新生儿乙肝免疫球蛋白和乙肝疫苗联合应用能够有效降低HBsAg阳性情况患者所产新生儿HBV感染率,同时能使新生儿对应的HBsAb转阳率有效提高,最终使HBV的传播阻断率提高。     

用荧光探针定量多聚酶链反应技术检测乙肝病毒宫内传播的研究

目的探讨孕妇血中乙肝病毒(HBV)DNA数量与宫内传播的关系.方法用荧光探针定量多聚酶链反应(FQ-PCR)方法,检测76例乙肝病毒表面抗原(HBsAg)阳性孕妇血清中HBV DNA数量.26例HBV DNA阳性者肌注乙肝免疫球蛋白,新生儿出生后24h内取末梢静脉血检测HBV DNA.结果孕妇血中HBV DNA阳性者其宫内感染率为33.3%,宫内感染与孕妇血中HBV DNA数量有关,HBV DNA数量高易导致胎儿宫内感染,乙肝免疫球蛋白免疫注射后可降低HBV宫内感染率.结论孕妇血中HBV DNA数量高易导致胎儿宫内感染,孕期应用乙肝免疫球蛋白可减少宫内传播.     

联合免疫预防乙型肝炎病毒宫内感染的临床观察

目的:探讨孕妇主动与被动联合免疫乙型肝炎病毒(HBV)宫内感染的作用和机理。方法:将106例HBsAg( )孕妇分成两组,预防组60例,自孕妇20周起多次注射乙肝疫苗(HBVac)和乙肝免疫球蛋白(HBIG);对照组46例,不用HBVac和HBIG。母婴血清HBsAg、HBeAg和HBsAb用固相放免法检测,HBV-DNA用有套式PCR检测。结果:预防组新生儿血清HBsAg和HBV-DNA检出率明显低于对照组(P<0.05);预防组新生儿HBsAb阳性率显著高于对照组(P<0.05)。结论:孕妇于孕期通过HBIG和HBVac联合免疫,可有效预防HBV宫内感染,其机理可能为胎儿获得被动免疫。     

不同方法阻断乙型肝炎病毒母婴垂直传播的临床观察

目的 探讨阻断乙型肝炎病毒母婴垂直传播的方法。方法 将94例HBsAg阳性孕妇分成4组,单纯HBVac治疗组29例,单纯HBIG治疗组19例,左旋咪唑涂布剂加两者联合应用13例,未治疗组33例,均在孕26周起开始注射,孕妇和新生儿血清HBsAg,抗－HBs,HBeAg,抗－HBe,抗－HBc检测采用ELISA法。94例孕妇按分娩方式不同分别观察对乙肝病毒母婴传播的影响。结果 脐血中HBsAg阳性率,HBVac治疗组为17．24％,HBIG治疗组为5．26％,联合治疗组为0,未治疗组为21．21％。在不同的分娩方式中,急症剖宫产新生儿脐血HBsAg阳性率为0,行择期剖宫产者为10．5％,经阴道分娩者为16．9％。结论 携带HBV孕妇于孕晚期给予HBVac,HBIG和左旋咪唑涂布剂联合两者治疗后,可有效阻断HBV母婴之间传播,以联合治疗组效果最佳,剖宫产术有助于阻断HBV母婴传播。     

HBIG阻断乙型肝炎病毒母婴传播

目的:评价HBsAg阳性母亲孕晚期肌注HBIG(乙肝免疫球蛋白)及婴儿出生后HBIG联合乙肝疫苗对HBV母婴传播及慢性化阻断的效果. 方法:历史对照组只对婴儿进行乙肝疫苗的全程免疫;HBIG组母亲孕晚期3 mo每月肌注200 u的HBIG;婴儿出生时、半月龄时分别肌注200 u的HBIG,并常规接种乙肝疫苗. 随访两组婴儿HBsAg变化情况,采用历史对照临床试验评价母亲及新生儿注射HBIG对HBV母婴传播及慢性化的阻断效果. 结果:历史对照组HBV宫内感染率5.34%,随访时婴儿HBsAg转阳率5.15%,HBV感染慢性化率87.5%;HBIG组分别为5.26%,0,18.18%. 经统计学检验,两组HBV宫内感染率无显著差异(P=1.000),但婴儿HBsAg转阳率及HBV感染慢性化率具有显著差异(P分别为0.019, 0.001). 结论:母亲孕晚期注射HBIG对阻断HBV宫内传播效果不明显;母亲及新生儿注射HBIG可显著提高乙肝疫苗对婴儿出生后HBsAg阳转及HBV感染慢性化的阻断效果.     

联合免疫预防乙型肝炎病毒宫内感染106例临床观察

目的:探讨孕妇主动与被动联合免疫乙型肝炎病毒(HBV)宫内感染的作用和机理。方法:将106例HBsAg( )孕妇分成两组,预防组60例,自孕妇20周起多次注射乙肝疫苗(HBVac)和乙肝免疫球蛋白(HB IG);对照组46例,不用HBVac和HB IG。母婴血清HBsAg、HBeAg和HBs用固相放免法检测,HBV-DNA用有套式PCR检测。结果:预防组新生儿血清HBsAg和HBV-DNA检出率明显低于对照组(3.3%)与26.1,10%与34.8%)均<0.05;预防组新生儿抗-HBs阳性率显著高于对照组(33.3%与8.7%)P<0.05。结论:孕妇于孕期通过HB IG和HBVac免疫,可有效预防HBV宫内感染,其机理可能为胎儿获得被动免疫。     

乙型肝炎免疫球蛋白阻断HBV宫内感染的效果观察

目的了解孕期乙肝免疫球蛋白(HBIG)阻断乙肝病毒宫内感染的疗效。方法选择2009-2010年在我院产科门诊定期产前检查并住院分娩的HBsAg阳性孕妇360例,观察组196例,于孕28、32、36周肌注HBIG 200IU,对照组164例不用药。用酶联免疫吸附试验(ELISA)和荧光定量PCR检测2组新生儿采股静脉血,检测乙肝病毒标志物和HBV-DNA。结果 HBIG对HBsAg单阳性和合并抗-HBe、抗-HBc阳性率分别为6.35%、22.81%和12.50%、32.20%,2组差异有统计学意义(P<0.05)。合并HBeAg、抗-HBc的阳性率为7.25%和16.67%,2组差异无统计学意义(P>0.05)。结论孕妇于孕晚期多次肌注HBIG进行被动免疫,可阻断HBV宫内感染,但HbeAg阳性产妇阻断无明显效果。     

拉米夫定阻断乙型肝炎病毒母婴传播的疗效观察

目的:评价妊娠中期应用拉米夫定对乙型肝炎病毒(HBV)传播的影响及安全性,寻求最佳预防宫内传播的方法。方法:拉米夫定组52例孕妇于孕20~26周开始服用拉米夫定100mg/d至分娩后,乙型肝炎免疫球蛋白(HBIG)组61例孕妇于孕28周开始使用HBIG 200 IU行宫内阻断治疗,2组新生儿出生均予主、被动联合免疫,观察新生儿宫内感染发生情况、抗病毒疗效及母婴异常情况,随访到婴儿1岁,并分别在0、1、7、12个月龄时监测其血清HBVDNA、HBsAg和抗-HBs定量变化。数据行t检验和χ2检验。结果:拉米夫定组孕妇于分娩前HBV DNA显著下降(t=18.72,P<0.05),转阴率为34.6%,肝功能异常者全部恢复正常。该组52例新生儿随访至1月龄时HBsAg或HBV DNA均为阴性,宫内感染率为0,与HBIG组宫内感染率(14.8%)相比,差异有统计学意义(χ2=9.40,P<0.05)。2组婴儿1岁时的血清抗-HBS水平无差异(t=0.71,P>0.05),拉米夫定组HBV慢性感染为0,HBIG组9例宫内感染婴儿均为HBsAg、HBeAg、抗-HBc、HBV DNA阳性,2组孕妇及婴儿均未发现不良反应。结论:对于HBV水平较高的孕妇,妊娠中期采用拉米夫定降低病毒含量,阻断HBV母婴垂直传播(宫内传播及产时传播)是行之有效的,且用药安全,未见明显不良反应。     

穴位注射乙型肝炎免疫球蛋白阻断乙型肝炎病毒母婴传播的临床研究

目的　探讨乙型肝炎病毒 (HBV) 阳性孕妇孕期足三里穴位注射乙型肝炎免疫球蛋白 (HBIg) 预防HBV宫内感染的作用效果。方法　2001年 11月~2003年 10月青岛大学医学院附属烟台毓璜顶医院将 190例乙肝表面抗原 (HBsAg) 阳性孕妇分为两组: 足三里穴位注射组 92例, 于孕 20、24、28、32、36周足三里穴位注射HBIg共 5次, 每次 200IU。肌肉注射组 98例, 于相同时间肌肉注射HBIg。采用酶联免疫法, 检测用药前、后孕妇血清及新生儿脐血清的HBsAg、HBeAg及HBsAb, 采用核酸扩增 (PCR) 荧光定量法检测HBV-DNA含量。结果　92例足三里穴位注射者, 新生儿宫内感染 8例, 宫内感染率为 8 7%, 低于肌肉注射组 (P<0 01)。穴位注射组新生儿脐血清HB sAb检出率显著高于肌肉注射组 (P<0 05)。穴位注射组临产前血清中HBV-DNA含量显著低于肌肉注射组 (P<0 05)。结论　孕妇通过足三里穴位注射HBIg, 可有效减少HBV的宫内感染, 未发现任何副作用。