不同方案阻断乙肝病毒母婴垂直传播的临床研究

探讨阻断乙型肝炎病毒母婴垂直传播的方法。将122例HBsAg( )孕妇分成四组,HBVac治疗组29例,HBIG组29例。左旋咪唑涂布剂与以上两者联合应用30例。未治疗组34例。均在孕26周开始干预观察,孕妇和新生儿血清HBV标志物（HBVM）检测采用ELISA法,122例孕妇按分娩方式不同分别观察对乙肝病毒母婴垂直传播影响;随访产妇及新生儿HBVM变化。脐血中HBsAg阳性率;HBVac治疗组为17.24%。HBIG治疗组为10.35%。联合治疗组为3.33%。未治疗组为23.53%。在不同的分娩方式中,急症剖宫产新生儿脐血HBsAg阳性率为13.04%,行择期剖宫产者为0,经阴道分娩者为16.67%。携带HBV孕妇于孕晚期给予HBVac,HBIG和左旋咪唑涂布剂联合以上两者治疗后,可有效阻断母婴之间传播。以联合治疗组效果最佳。不同分娩方式也影响传播,剖宫产术有助于阻断HBV母婴传播。

Clinical study on preventing mother- infant vertical transmission of hepatitis B virus

To probe preventing methods on mother - infant vertical transmission of Hepatitis B virus, 122 pregnant women with HBsAg positive were divided into four groups. 29 cases were injected with hepatitis B vaccine, 29 cases were injected with hepatitis B immunoglobulin (HBIG); 30 cases were used levamisole liniment combined with injection of both HBV ac and HBIG during pregnancy since the 26th week of gestation; and 30 cases was regarded as control group without any treatment. Serologic HBV markers (HBVM) of pregnant women and newborns umbilical blood were detected by ELISA. These women were divided into two groups by delivery manner. HBsAg positive rate of newborns umbilical blood were different among three treated groups: 17.24% for HBVac group.10. 35% for HBIG group.3. 33% for HBVac and HBIG and levamisole liniment group. By different delivery manier, infection rate of emergent caesarean section, selected caesarean section and vaginal delivery were 13. 04%, 0, and 16. 67%, respectively. Immunization with HBVac or HBIG or both add levamisole liniment during pregnany may prevent intrauterine HBV infection effectively. In order to decrease transmission of mother - infant, selected caesarean birth should be adopted.