阻断乙型肝炎病毒父婴传播的研究

目的：探讨阻断乙型肝炎病毒父婴垂直传播的有效方法.方法：选取120例孕妇抗-HBs（＋）,配偶血清HBV-DNA（＋）为研究对象（观察组）,并根据孕期是否肌注乙肝免疫球蛋白分2组：Ⅰ组自孕28周开始,每4周肌注乙肝免疫球蛋白200 IU至分娩,Ⅱ组孕期不肌注乙肝免疫球蛋白.另筛选出孕妇无各种肝炎病毒感染且抗-HBs（-）,配偶血清HBV-DNA（＋）的病例60例为对照组（Ⅲ组）.3组新生儿出生时均抽脐带血检测HBV-DNA及抗-HBs.结果：Ⅰ组新生儿抗-HBs阳性率为55.00％,Ⅱ组新生儿抗-HBs阳性率为51.67％,对照组新生儿抗-HBs（＋）为0,观察组新生儿抗-HBs阳性率显著高于对照组（P＜0.05）.工组新生儿脐血HBV-DNA（＋）23.33％,Ⅱ组脐血HBV-DNA（＋）25.00％,Ⅲ组43.33％,观察组新生儿感染率明显低于对照组（P＜0.05）.结论：对配偶血清HBV-DNA（＋）的孕妇在孕前接种乙肝疫苗成功获得抗-HBs（＋）,可有效阻断父婴传播.

A study of interrupting the vertical transmission of hepatitis B virus from father to infant

Objective： To investigate the effective method of interrupting the vertical transmission of the hepatitis B virus （HBV） from father to infant. Methods： 120 couples with serum HBV-DNA positive in men and anti-HBs positive in women were selected as subjects and they were divided into Group Ⅱ and Group Ⅱ based on whether they were injected with hepatitis B specific immunoglobulin. Women in Group Ⅰ were injected with hepatitis B specific immunoglobulin 200 IU monthly since the 28th week duration of pregnancy and women in Group Ⅱ weren＇t injected with hepatitis B specific imrnunoglobulin. Another 60 couples with serum HBV-DNA positive in men and without hepatitis virus infection in women were selected as the control group （Group Ⅲ ）. The anti-HBs and HBV-DNA of the neonates in the 3 groups were all determined after birth by testing the serum of cord blood. Results： Positive rate of anti-HBs of infants in Group Ⅰ , Group and Group Ⅲ were 55.00%, 51.67%, 0.00% respectively. The positive rate of anti-HBs in Group Ⅰ and Ⅱ was obviously higher than that in the control group （P〈0.05）. 23.33% of neonates in Group Ⅰ and 25.00% of neonates in Group Ⅱ and 43.33 % of neonates in Group Ill were infected by HBV. The infection rate of HBV in the observation group was significantly lower than that in control group （P〈0.05）. Conclusions. Successful passive immunity of women whose husbands were with HBV-DNA positive before pregnancy is an important way to block the paternal-fetal transmission of HBV.