乙肝疫苗与球蛋白对宫内乙肝病毒感染的控制

目的　对乙肝疫苗联合乙肝免疫球蛋白控制宫内乙肝病毒感染进行前瞻性研究。方法　将纳入研究的 131例乙肝检测阳性孕妇分为 4组 ,分别予以单用乙肝免疫球蛋白、乙肝疫苗联合乙肝免疫球蛋白、单用乙肝疫苗及空白对照。每个病例均作孕妇体内HBsAg、HBV DNA定量检测及新生儿出生即刻的股静脉血中HBV系列检测 ,以了解宫内感染的发生率。结果　在全程单用乙肝免疫球蛋白组和乙肝疫苗联合乙肝免疫球蛋白组新生儿宫内感染率都为 3% ,与对照组比较有显著性差异 ,P <0 .0 5 ,而单用乙肝疫苗组为 10 .7% ,对照组为 17.2 % ,两组比较差异有显著性 ,P <0 .0 5。结论　应用乙肝疫苗联合乙肝免疫球蛋白既可降低乙肝病毒携带HBeAg(+)孕妇的宫内感染 ,又可节约阻断成本。

Control of intrauterine HBV infection by combination of HBV vaccine and HBV immunoglobulin

Objective To investigate prospectively therapeutic effect of combinati on of HBV vaccine and HBV immunoglobulin for controlling intrauterine HBV infect ion. Methods 131pregnant women with positive HBsAg,HBeAg and HBV-DNA were divi de d into 4 groups: single use of HBV immunoglobulin group, combination of HBV vacc ine and HBV immunoglobulin group, single use of HBV vaccine group and control gr oup. For each case, maternal quantitative tests of HBsAg, HBV-DNA and neonatal H BV series tests for femoral venous blood of neonates immediately after birth wer e conducted to l earn the incidence of HBV intrauterine infection. Results The rates of neonatal HBV intrauterine infection both in full course of HBV immunoglobulin group a nd full course of combination of HBV vaccine and HBV immunoglobulin group, were all 3%. As compared with control group, there were significant differences (P < 0.05). While the rate of intrauterine fetal HBV infection in single use of HBV vaccine group was 10.7% and that in control group was 17.2%, and there was sign ificant difference between the two groups (P<0.05). Conclusion: Combinatio n of HBV vaccine and HBV immunoglobulin can not only decrease incidence of intra uteri ne HBV infection of those pregnant women with positive HBeAg, but also save the block cost.