乙型肝炎患者血清中HBcAg与HBV复制指标的关系

目的探讨乙型肝炎患者血清ＨＢｃＡｇ与ＨＢＶ复制指标的关系及临床意义．方法对３１１例乙型肝炎患者进行了ＨＢｃＡｇ检测，并同时进行酶联法乙肝五项、地高辛法ＨＢＶＤＮＡ检测，其中２３７例进行乙肝ＤＮＡ聚合酶（ＤＮＡＰ）检测．结果ＨＢｃＡｇ阳性组的ＨＢＶＤＮＡ检出率（７７６％），明显高于ＨＢｃＡｇ阴性组（３５５％，Ｐ＜００１）；在ＨＢｃＡｇ阴性组中，抗ＨＢｅ阳性者仍能检出２９９％（４４／１４７）ＨＢＶＤＮＡ者阳性；ＨＢｅＡｇ，ＨＢｃＡｇ均阳性者其ＨＢＶＤＮＡ和ＤＮＡＰ的检出率高达８５９％；其他依次为ＨＢｅＡｇ、抗ＨＢｅ和ＨＢｃＡｇ均阳性者７１４％，抗ＨＢｅ，ＨＢｃＡｇ阳性者６９２％，ＨＢｅＡｇ阳性，ＨＢｃＡｇ阴性者６８４％，抗ＨＢｅ阳性，ＨＢｃＡｇ阴性者２７６％．结论血清ＨＢＶＤＮＡ，ＤＮＡＰ，ＨＢｅＡｇ和ＨＢｃＡｇ均是反映乙肝病毒复制的敏感指标，抗ＨＢｅ的出现并不表示病毒复制停止，应参考其他病毒复制指标情况．各种指标的不同组合可以清楚地反映出患者体内病毒复制状况．     

PCR检测HBV感染患者血清HBV DNA的临床意义

目的探讨急、慢性乙型肝炎及与ＨＢＶ感染相关的肝硬变和肝癌患者血清ＨＢＶＤＮＡ的临床意义．方法应用ＰＣＲ技术检测不同ＨＢＶ感染２０５例，患者血清ＨＢＶＤＮＡ，并与正常人２０例作比较．结果ＨＢＶ感染患者２０５例血清ＨＢＶＤＮＡ阳性率为６９３％，慢性乙肝、乙肝后肝硬变和肝癌患者的阳性率分别为７６４％，７１９％和７００％，显著高于急性乙肝患者２１７％的阳性率（Ｐ＜００１）；ＨＢｅＡｇ（＋）患者血清ＨＢＶＤＮＡ阳性率为９３６％，显著高于ＨＢｅＡｇ（－）抗ＨＢｅ（＋）／（－）和ＨＢｓＡｇ（－）患者的阳性率（４５６％，２５０％和１２５％，Ｐ＜００１）；血清ＨＢＶＤＮＡ阳性和阴性两组患者的血清ＡＬＴ水平无明显差异（Ｐ＞００５）．结论血清中ＨＢＶＤＮＡ持续存在可能与乙型肝炎的慢性化有关，而与ＨＢＶ感染患者的肝损伤无明显关系     

乙型肝炎患者血清Pre-S-2抗原的意义

目的研究ＰｒｅＳ２抗原与乙型肝炎患者ＨＢＶ标记的关系．方法血清ＨＢｓＡｇ（＋），ＨＢｅＡｇ（＋），ＨＢｃＡｂ（＋）的乙型肝炎患者２６例，血清ＨＢｓＡｇ（＋），ＨＢｅＡｂ（＋），ＨＢｃＡｂ（＋）的乙型肝炎患者４７例及健康献血者２０例，血清用ＲＩＡ法检测ＰｒｅＳ２抗原及用ＰＣＲ法检测ＨＢＶＤＮＡ．结果血清ＨＢｓＡｇ（＋），ＨＢｅＡｇ（＋），ＨＢｃＡｂ（＋）的乙型肝炎患者２６例，ＰｒｅＳ２抗原与ＨＢＶＤＮＡ均阳性（１００％）；血清ＨＢｓＡｇ（＋），ＨＢｅＡｂ（＋），ＨＢｃＡｂ（＋）的乙型肝炎患者４７例，ＰｒｅＳ２抗原３０例阳性（６３８％），１７例阴性（３６２％），ＨＢＶＤＮＡ３２例阳性（６８１％），１５例阴性（３１９％），ＰｒｅＳ２抗原与ＨＢＶＤＮＡ均阳性２８例（５９６％），均阴性１４例（３００％）．健康献血者２０例，ＰｒｅＳ２抗原阳性１例（５０％），阴性１９例（９５０％），ＨＢＶＤＮＡ阳性２例（１００％），阴性１８例（８００％），ＰｒｅＳ２抗原及ＨＢＶＤＮＡ均阳性０例（０％），均阴性１８例（８００％）．结论ＰｒｅＳ２抗原可作为预测慢性乙型肝炎患者病情活动与传染的标志．     

血清抗-HBs阳性慢性肝病患者的病因研究

目的部分抗－ＨＢｓ阳性者仍有活动性肝病存在，其病因还不十分清楚．本研究旨在探讨血清抗ＨＢｓ阳性慢性肝病患者的病因．方法应用套式聚合酶链反应检测血清抗ＨＢｓ阳性慢性肝病患者血清中ＨＢＶＤＮＡ和ＨＣＶＲＮＡ．患者３２例，男２５例，女７例，平均年龄４１７岁（２１岁～６３岁），其中慢性肝炎１８例，肝硬变１４例．９例慢性肝炎和５例肝硬变经肝活检证实，其余为临床诊断．结果血清中ＨＢＶＤＮＡ和ＨＣＶＲＮＡ的检出率分别为６２５％（２０／３２）和２８１％（９／３２）；ＨＢＶＤＮＡ和（或）ＨＣＶＲＮＡ总检出率为８１３％（２６／３２）．结论血清抗ＨＢｓ阳性慢性肝病患者的病因多数与ＨＢＶ和（或）ＨＣＶ感染有关．     

血清HBeAg阴性与HBeAg/IC及A1896变异的关系

目的探讨血清ＨＢｅＡｇ阴性（双抗体夹心法）与ＨＢｅＡｇ／ＩＣ形成及ＨＢＶ变异株Ａ１８９６的关系，评价ＨＢｅＡｇ／ＩＣ检测的临床意义．方法单克隆抗ＨＢｅ固相ＥＬＩＳＡ检测血清中ＨＢｅＡｇ／ＩＣ；套式多聚酶链反应检测ＨＢＶＤＮＡ；３＇碱基特异多聚酶链反应判断Ａ１８９６变异；ＥＬＩＳＡ检测ＨＢｅＡｇ、抗ＨＢｅ，研究对象为１１７例慢性ＨＢＶ感染者，２０例健康对照统计处理采用卡方检验．结果ＨＢｅＡｇ／ＩＣ阳性血清中ＨＢＶＤＮＡ检出率明显高于ＨＢｅＡｇ／ＩＣ阴性血清，Ｐ＜０００１（９１３％ｖｓ３６２％）；２９份ＨＢｅＡｇ阴性、ＨＢＶＤＮＡ阳性血清中仅５例（１７２％）检出Ａ１８９６，而且其中２例与野毒株（Ｇ１８９６）混合感染并伴ＨＢｅＡｇ／ＩＣ阳性．２９份中１７份（５８７％）为ＨＢｅＡｇ／ＩＣ阳性的Ｇ１８９６感染；血清抗ＨＢｅ阳性组Ａ１８９６检出率高于抗ＨＢｅ阴性组，Ｐ＜００５（２５％ｖｓ３２％）．结论ＨＢｅＡｇ／ＩＣ为ＨＢＶ活跃复制指标；临床ＨＢｅＡｇ阴性、ＨＢＶＤＮＡ阳性患者仍多数为Ｇ１８９６感染，ＨＢｅＡｇ／ＩＣ形致双抗体夹心法不能检出ＨＢｅＡｇ；抗ＨＢｅ应答可能为促使前Ｃ变异的重要因素     

CPH肝组织,血清HBV与血清HBV标志物不同状态的相关性探讨

目的和方法：经肝活检诊断为慢性迁延性肝炎（ＣＰＨ）５１例，均做ＰＣＲ、斑点杂交进行肝组织、血清ＨＢＶＤＮＡ检测，同时用ＥＬＩＳＡ方法检测了ＨＢＶ血清标志物。结果，ＨＢＶＤＮＡ检出率依次为肝组织ＰＣＲ９４１％（４８／５１）、血清ＰＣＲ９２２％（４７／５１）和肝组织斑点杂交９０２％（４６／５１）。三者之间无显著差异（χ２＝０４９５，Ｐ＞００５）。各项血清标志物总检出率ＨＢｓＡｇ３７２％（１９／５１），ＨＢｅＡｇ３３３％（１７／５１）和抗－ＨＢｅ２１５％（１１／１５），显著低于ＰＣＲ和斑点杂交ＨＢＶＤＮＡ的检出率（χ２＝３０．９，Ｐ＜０００５）。在抗－ＨＢｅ（＋）的１１例患者中１０例检出肝组织和血清ＨＢＶＤＮＡ，８例抗－ＨＢｓ（＋）患者，６例肝组织及血清ＰＣＲＨＢＶＤＮＡ阳性，结论：表明抗－ＨＢｅ（＋）及／或抗－ＨＢｓ（＋）不能代表ＨＢＶ复制停止或被清除，并且肝脏病变可仍然存在     

HBV 侵犯PBMC致线粒体功能改变

目的探讨ＨＢＶ侵犯外周血单个核细胞（ＰＢＭＣ）后对其线粒体功能的影响．方法ＨＢｓＡｇ阳性６个月以上，无肝炎症状及体征，肝功正常患者５８例．多聚酶链反应检测ＰＢＭＣ中ＨＢＶＤＮＡ，噻唑兰（ＭＴＴ）比色法测线粒体功能．ＨＢｓＡｇ、ＨＢｅＡｇ检测用固相放免法检测．结果慢性ＨＢＶ感染者５８例，ＰＢＭＣ中检出ＨＢＶＤＮＡ３１例（５３５％），ＰＢＭＣ中ＨＢＶＤＮＡ阳性组ＭＴＴ比色法查线粒体功能的Ａ（ＯＤ５００ｎｍ）值明显低于ＨＢＶＤＮＡ阴性组（００５±００３ｖｓ０２９±００７，Ｐ＜００１）．结论慢性ＨＢＶ感染时，ＨＢＶ常侵犯ＰＢＭＣ，并导致ＰＢＭＣ线粒体功能降低、能量代谢异常．这可为ＨＢＶ慢性感染免疫功能异常的原因之一．     

芹灵冲剂治疗慢性乙型肝炎102例的临床研究

目的观察芹灵冲剂对慢性乙型肝炎患者的治疗效果．方法慢性乙型肝炎患者１０２例，应用芹灵冲剂（水芹等两味中药组成）进行治疗，男８４例，女１８例；年龄１６岁～５４岁，其中２０岁～４５岁８７例（７７４％）；病程６ｍｏ～５ａ，其中１ａ～４ａ者７８例（６５６％）；全部病例治疗前肝功能均不正常，ＨＢｓＡｇ、ＨＢｅＡｇ和抗ＨＢｃ均为阳性，食少纳差，全身无力等．治疗组服药１～２包（相当生药１０ｇ／包），３次／ｄ，３０ｄ为１疗程，一般２～３个疗程．对照组６０例，男３５例，女２５例；年龄２０岁～６５岁．治疗前肝功能均不正常，ＨＢｓＡｇ、ＨＢｅＡｇ和抗ＨＢｃ均为阳性；病程６ｍｏ～６ａ；服用益肝灵４片，３次／ｄ，疗程同上．每疗程结束后两组患者均复查肝功能和乙肝抗原抗体一次．在治疗中均辅用葡萄糖，维生素Ｃ，能量合剂等保肝药物．结果经芹灵冲剂治疗２～３疗程后，显效４６例，有效５３例，无效３例，总有效率为９７１％．所有病例降酶率为９６１％，退黄率为９８０％；ＨＢｓＡｇ转阴率为４５１％、ＨＢｅＡｇ为５３９％，抗ＨＢｃ为４８６％．服药期间未见明显毒副反应．结论芹灵冲剂对慢性乙型肝炎患者具有退黄降酶、抗乙肝病毒的良好效果．     

乙型肝炎病毒核心区基因免疫小鼠细胞免疫应答研究

目的观察小鼠对ＨＢＶ核心区基因疫苗的免疫应答。方法将经过基因修饰的乙型肝炎病毒核心区基因定向克隆于真核表达载体（ｐｃＤＮＡ３），构建成ＨＢＶ核心区基因疫苗（ｐｃＤＮＡ－ＨＢＶ），给Ｂａｌｂ／ｃ小鼠多点肌肉注射，２周后追加免疫一次，用竞争抑制酶联法及ＭＴＴ法检测小鼠血清抗－ＨＢｃ及脾细胞对ＨＢｃＡｇ的特异性增殖反应。结果免疫接种２周后小鼠血清抗－ＨＢｃ均阳性，持续１２周以上，脾细胞对ＨＢｃＡｇ的刺激指数明显高于对照组（Ｐ＜０．０５）。结论ｐｃＤＮＡ－ＨＢＶ在Ｂａｌｂ／ｃ小鼠体内既可诱导体液免疫应答，又可诱导特异性的细胞免疫应答     

用PCR技术检测HBV－DNA的临床意义

用ＰＣＲ技术对３２３例肝病患者和５０例健康献血员血清进行ＨＢＶ－ＤＮＡ检测，同时用ＥＬＩＳＡ法检测ＨＢＶＭ。结果：５０例健康献血员有８％ＨＢＶ－ＤＮＡ阳性，表明ＨＢＶ－ＤＮＡ单项阳性的携带者对于乙肝的传播具有很大的危险性；ＨＢｓＡｇ、ＨＢｅＡｇ、抗ＨＢｃ阳性者ＨＢＶ－ＤＮＡ检出率为８８．７％，说明ＨＢＶ－ＤＮＡ与ＨＢｅＡｇ阳性呈正相关；抗ＨＢｅ阳性的慢性肝病患者有４３．６８％ＨＢＶ－ＤＮＡ阳性，提示不能把抗ＨＢｅ作为无传染性的指标。     

慢性丙型肝炎的组织学特点和分类

目的研究慢性丙型肝炎的组织病理学特点和新的病变程度的分类，并与慢性乙型肝炎作比较。方法对４９例慢性丙型肝炎和４５例慢性乙型肝炎的肝组织标本，由三位病理科医师双盲读片，记录主要的组织学改变，并根据新老慢性肝炎分类评估。结果慢性丙型肝炎最为突出的组织学改变为肝脂肪变（６１％）、胆管损害（５７％）、肝窦内炎症细胞（４７％）和淋巴细胞聚集（４３％），均较慢性乙型肝炎多见，差异有显著性。本组病例按新的国际分级、分期与传统的慢活肝、慢迁肝的分类比较，二者之间有一定的相关性，但前者更能准确反映病变的程度。结论新的慢性肝炎的组织学分类法优于传统的分类法。值得推广。     

慢性乙型肝炎抗病毒药物治疗的评价

本文对慢性乙型肝炎抗病毒芗治疗的应答反应作一评价。单一治疗：干扰素－α：治疗前血清ALT水平升高者，30％－40％患者对治疗呈完全应答反应，HBV携带者或免疫耐受者对治疗无效；拉米夫定：能明显抑制BV复制，但HBeAg转阴者少，停药后HBV－DNA迅速反跳，延长治疗时间可引起YMDD变异；治疗前血清ALT水平在正常上限5倍以上者，60％患者呈完全应答反应；法昔洛维：抑制HBV复制作用弱，且较短暂，长期用药可引起基因突变，发生耐药性。联合治疗：拉米夫定－干扰素、拉米夫定－法昔洛维／阿地洛维、强的松－拉米夫定／干扰素等联合应用。联合治疗可降低HBV负荷，改善CD4＋－T细胞功能及减少耐药性。     

拉米夫定治疗重型乙型病毒性肝炎的临床研究

目的 :探讨拉米夫定治疗慢性乙型重型病毒性肝炎的疗效和安全性。方法 :86例慢性乙型重型病毒性肝炎分为两组。对照组 3 8例 ,给予常规内科综合治疗 ;拉米夫定组 48例 ,在综合治疗的基础上 ,加用拉米夫定。统计两组的病死率、存活者肝功能恢复情况及平均住院时间。结果 :治疗组患者病死率为 41 7% ,对照组为 68 4% ,两组患者病死率经统计学处理差异有显著性意义 (P <0 0 5 ) ;治疗组存活者达到显效出院平均住院时间为 (74 6±2 2 7)天 ,明显短于对照组的 (114 3± 2 6 2 )天 (P <0 0 5 )。拉米夫定治疗期间未见明显副反应 ,显示良好的安全性。结论 :拉米夫定治疗慢性乙型重型病毒性肝炎是有效和安全的 ,可作为抢救重型乙型肝炎的治疗药物之一。     

Advances in treatment and prevention of hepatitis B

Chronic hepatitis B(CHB) continues to contribute to worldwide morbidity and mortality significantly. Scientists, clinicians, pharmaceutical companies, and health organizations have dedicated substantial Intellectual and monetary resources to finding a cure, increasing immunization rates, and reducing the global burden of CHB. National and international health-related organizations including the center for disease control, the national institute of health, the American Association for the study of liver disease(AASLD), The European association for the study of the Liver(EASL), The Asia Pacific association for the study of the Liver(APASL) and the world health organization release periodic recommendations for disease prevention and treatment. Our review of the most recent guidelines by EASL, AASLD, APASL, and Taiwan Association for the Study of the Liver revealed that an overwhelming majority of cited studies were published before 2018. We reviewed Hepatitis B-related literature published 2018 onwards to identify recent developments and current barriers that will likely direct future efforts towards eradicating hepatitis B. The breakthrough in our understanding of the hepatitis B virus life cycle and resulting drug development is encouraging with significant room for further progress. Data from high-risk populations, most vulnerable to the devastating effects of hepatitis B infection and reactivation remain sparse. Utilization of systems approach, optimization of experimental models, identification and validation of next-generation biomarkers, and precise modulation of the human immune response will be critical for future innovation. Within the foreseeable future, new treatments will likely complement conventional therapies rather than replace them. Most Importantly, pragmatic management of CHB related population health challenges must be prioritized to produce real-world results.     

Maternal knowledge of the risk of vertical transmission and offspring acquisition of hepatitis B

Introduction and objectivesUniversal vaccination at birth and in infancy is key to the elimination of chronic hepatitis B infection. We aimed to assess hepatitis B immune-prophylaxis and perinatal transmission knowledge, in a large and ethnically diverse cohort of previously pregnant North American women, chronically infected with hepatitis B.Materials and methodsThe Hepatitis B Research Network (HBRN) is comprised of 28 Clinical Centers in the United States and Canada. Female cohort participants were administered a questionnaire to assess: (1) their assertion of knowledge regarding HBV prophylaxis at birth, testing, and diagnosis of hepatitis B in their children, and (2) the percentage of affirmative to negative responses for each of the HBV-related interventions her child may have received. The relationship between asserted knowledge, actions taken and maternal demographics were assessed.ResultsA total of 351 mothers with 627 children born in or after 1992 were included. Median age at enrollment was 39.8 years. Mothers were mostly foreign-born with the largest percentage from Asia (73.4%) and Africa (11.7%). Of the 627 children, 94.5% had mothers who asserted that they knew whether their child had received HBIG or HBV vaccine at birth, for 88.8% of the children, their mothers indicated that they knew if their child was tested for HBV and for 84.5% of children, their mothers knew if the child was diagnosed with HBV infection. Among children whose mothers asserted knowledge of their HBV management, 95.3% were reported to have received HBIG or HBV vaccine, 83.4% of children were said to have been tested for HBV, and 4.8% of children were said to have been diagnosed with HBV. Younger maternal age was the only factor significantly associated with higher percentage of children for whom mothers reported knowledge of testing (p = 0.02) or diagnosis of HBV (p = 0.02).ConclusionsWhile high percentages of North American children had mothers asserting knowledge of HBV prophylaxis and testing, knowledge gaps remain, with mothers of 5.5–15.5% of children lacking knowledge of key components of the HBV prevention and diagnosis in the perinatal setting. Targeted education of HBsAg-positive mothers may aid in closing this gap and reducing vertical transmission.     

拉米夫定治疗其他方法抗病毒治疗失败的慢性乙型肝炎患者的疗效

目的观察拉米夫定对复发性慢性乙型肝炎患者的疗效和安全性。方法选择27例其他方法抗病毒治疗失败的慢性乙型肝炎患者,给予拉米夫定100mg口服,每日一次,连续服用12个月。结果治疗后12个月时ALT和血清总胆红素平均值(分别为52.7±26.5U/L和19.7±21.1μmol/L),与治疗前平均值(211.3±182.4U/L和54.6±28.8μmol/L)相比显著下降(P<0.01);其ALT复常率为88.9%(24/27),HBV DNA阴转率77.8%(21/27),HBeAg阴转率29.6%(8/27),HBeAg/抗-HBe血清转换率18.5%(5/27)。停药后6个月内有7例复发。治疗全程未见严重不良反应。结论拉米夫定治疗其他方法抗病毒治疗失败的慢性乙型肝炎患者也能够迅速抑制病毒的复制,使肝功能复常,而且安全、方便。     

拉米夫定治疗慢性乙型肝炎病人的长期疗效

通过多中心,承机,双盲,安慰剂对照的临床试验,研究拉米夫定（ｌａｍｉｖｕｄｉｎｅ）对慢性乙型肝炎（乙肝）病人的疗效和安全性。方法随机选择３２２例慢性乙肝病拉米夫定治疗（１００ｍｇ／ｄ）,１０７例病人服用安慰剂作对照,共治疗１２周,在１２周治疗结束后,拉米夫定组和安慰剂组病人均继续服用拉米夫定１００ｍｇ治疗至５２周。疗效评估包括临床症状和体征,肝功能和ＨＢＶ复制指标。结果治疗１２周,拉米夫定组ＨＢＶ     

MiR-122 in hepatitis B virus and hepatitis C virus dual infection

Hepatitis B virus (HBV) and hepatitis C virus (HCV) infections are the most common causes of chronic liver diseases and hepatocelluar carcinomas. Over the past few years, the liver-enriched microRNA-122 (miR-122) has been shown to differentially regulate viral replication of HBV and HCV. It is notable that the level of miR-122 is positively and negatively regulated by HCV and HBV, respectively. Consistent with the well-documented phenomenon that miR-122 promotes HCV accumulation, inhibition of miR-122 has been shown as an effective therapy for the treatment of HCV infection in both chimpanzees and humans. On the other hand, miR-122 is also known to block HBV replication, and HBV has recently been shown to inhibit miR-122 expression; such a reciprocal inhibition between miR-122 and HBV suggests an intriguing possibility that miR-122 replacement may represent a potential therapy for treatment of HBV infection. As HBV and HCV have shared transmission routes, dual infection is not an uncommon scenario, which is associated with more advanced liver disease than either HBV or HCV mono-infection. Thus, there is a clear need to further understand the interaction between HBV and HCV and to delineate the role of miR-122 in HBV/HCV dual infection in order to devise effective therapy. This review summarizes the current understanding of HBV/HCV dual infection, focusing on the pathobiological role and therapeutic potential of miR-122.     

不同联合免疫策略对乙型肝炎病毒高载量孕妇所生婴儿抗-HBs水平的影响

目的 比较HBeAg阳性且HBV DNA高载量孕妇所生婴儿出生后应用不同剂量的乙型肝炎免疫球蛋白(HBIG)及乙型肝炎疫苗(HBVac)联合免疫接种后的母婴阻断效果,新生儿抗-HBs水平的差异. 方法 随机选取2009年至2013年我院产前检查并足月分娩的HBeAg阳性且建卡及临产均HBV DNA＞1×106 IU/ml孕妇所生婴儿118例,婴儿出生后抽血检查HBV标志物和HBVDNA定量,据产妇及家属意愿抽血后按注射HBIG及HBVac剂量的不同分为3组:A组:58例,予HBIG 200 IU及HBVac 20 μ g肌肉注射;B组:35例,予HBIG 200 IU及HBVac 10 μg肌肉注射;C组:25例,予HBIG 100 IU及HBVac 20 μg肌肉注射,随访至7月龄.婴儿出生至7月龄的HBsAg、抗-HBs、HBeAg、HBV DNA变化采用重复测量方差分析;组间比较采用x2检验,P＜ 0.05为差异有统计学意义.结果 除去5例宫内感染婴儿,113例婴儿免疫接种后均产生抗-HBs.完成HBIG注射后,A、B、C三组1月龄婴儿时抗-HBs滴度分别为(263.56±50.98) mIU/ml、(231.06±74.07) mIU/ml和(99.23±29.82) mIU/ml,C组分别与A、B组比较,t值分别为15.01、8.41,P值均＜0.001,差异均有统计学意义.A、B、C三组7月龄时婴儿抗-HBs滴度分别为(788.10±281.96) mIU/ml、(428.39±347.48) mIU/ml和(708.44±315.69) mIU/ml,B组与A、C组比较,t值分别为5.45、3.19,P值均＜0.05,差异均有统计学意义. 结论 HBeAg阳性高病毒载量孕妇所生非宫内感染儿出生后应用HBIG及HBVac免疫接种能获得较好的免疫保护,应用HBIG 200 IU较100 IU,HBVac 20 μg较10 μg更安全可靠.     

短程化疗中乙肝病毒标志物阳性对肝功能影响及处理

目的 探讨抗结核治疗中乙肝病毒感染对肝功能的影响及其对策。方法 回顾性分析1746例肺结核病人及其中160例药物性肝损害的相关临床资料。结果176例乙型肝炎病毒标志物(HBVM)阳性结核病人中有68例(38.6%)出现肝损害,HBVM阴性患者1490例中出现肝损害70例(4.7%),另有80例未测HBVM者中22例(27.5%)出现肝损害。HBVM阳性与阴性的肝损害发生率差异极显著(P<0.01)。在治疗过程中出现肝损时间多为15～90d。结论 短程化疗中乙肝病毒感染对肝功能有一定的影响,在抗结核治疗前检查HBVM及肝功能十分必要,对HBVM阳性者宜选择对肝脏损害较轻的药物,同时给予适当的护肝治疗,并密切监测肝功能的变化。