免疫阻断治疗对外周血单个核细胞感染HBV孕妇宫内感染率的影响

目的:探讨孕妇HBV感染外周血单个核细胞时,免疫阻断治疗对新生儿宫内感染率的影响。方法:HBsAg阳性孕妇34例,以套式PCR法测定治疗前外周血单个核细胞(PBMC)中HBVDNA,其中阳性14例(A组),阴性20例(B组),所有孕妇行乙肝免疫球蛋白少量多次肌注,测定新生儿血清HBsAg,血清HBVDNA,PBMC HBV-DNA。结果:A组新生儿宫内感染率为57.1%(8/14),B组新生儿宫内感染率为5%(1/20),两者比较有显著性差异(P<0.01)。结论:孕妇PBMC中HBVDNA阳性是新生儿宫内感染的高危因素,PBMC中HBVDNA是否阳性直接影响孕期免疫阻断治疗,降低宫内感染率的疗效。

The effect of immunization interrupting therapy on the intrauterine infected rate of mother with HBVDNA in peripheral blood mononuclear cell

Objective: To explore whether immunization interrupting therapy can reduce the the neonate intrauterine infected rate of mother with HBVDNA in peripheral blood mononuclear cell.Methods: Pregnant women with HBsAg positive(34 cases),whose HBVDNA in PBMC was tested by nested-PCR,were divided into two groups: group A were positive(14 cases);group B were negative(20 cases).All the cases were injected with Hepatitis B Immunnoglobulin(HBIG) at 20,24,28,32,36,38 week during pregnancy(200 IU per time).the HBsAg and HBV-DNA of serum and PBMC of neonates were tested respectively by ELISA and n-PCR.Results: The neonates infected rate(57.1%,8/14) of group A(PBMC HBV-DNA positive mothers)was significantly higher than the rate(5%,1/20) of group B(PBMC HBV-DNA negative mothers)(P<0.01).Conclusion: Mother's PBMC HBV-DNA positive is a high risk for neonates HBV intrauterine infection.Immunization interrupting therapy has little effect on HBV transmission caused by HBV infected PBMC,and can not reduce the neonate intrauterine infected rate.