乙肝孕妇所生婴儿乙肝感染情况的对照研究

目的:探讨孕妇不同的乙肝感染状态经被动免疫后所生婴儿乙肝感染情况。方法:将57例HBsAg阳性孕妇分为乙肝“大三阳”组及乙肝“小三阳”组,同时又分为被动免疫组和未被动免疫组。对被动免疫组从孕28周起1次/4周肌注乙肝免疫球蛋白,200 U/次,共3次,对其所生的婴儿于生后24 h、6个月及1岁时测定乙肝“两对半”。结果:经被动免疫孕妇所生婴儿抗HBs抗体产生率明显高于未被动免疫组(P<0.05)。乙肝“大三阳”孕妇孕期经被动免疫所生婴儿抗HBs抗体的产生率明显高于未经被动免疫的乙肝“大三阳”孕妇所生婴儿抗HBs抗体的产生率。乙肝“小三阳”孕妇经被动免疫和未被动免疫所生婴儿抗HBs抗体的产生率及乙肝感染率无明显差异。结论:被动免疫可以阻断乙肝宫内感染的发生,使婴儿在宫内得到被动免疫,乙肝“大三阳”孕妇是发生宫内感染的高危因素。

A case-control study on influence of neonatal infection by pregnant women with hepatitis B

Objective:To study the newborn infecting hepatitis B of carrier mothers by passive immunization of pregnant women and the newborn were been followed up.Methods:57 HBsAg positive pregnant women were divided into two groups,positive maternal HBsAg,HBeAg,HBcAb and positive HBsAg,HBeAb,HBcAb.At the meantime,they were divided into passive immunization group and no passive immunization group,In the passive immunization group,intramuscular injection of HBIG 200 U per 4 weeks from 28th week of pregnany.After that,All cases were detected of HBv-DNA and HBsAg,HBsAb,HBeAg,HBeAb,HBcAb in serum.The infant were detected after born,in 24 hours,6th month and 12th month.Results:The rate of HBsAb in the infant of passive immunization group with positive HBsAg,HBeAg,HBcAg was significantly higher than that of the no passive immunization group.The rate of HBsAb in the infant and infected was not significantly different in mothers with positive HBsAg,HBeAb,HBcAb.Infecting of infant was correlated with positive HBSg,HBeAg,HBcAg of their mother samples.Conclusion:Passive immunization can prevent intrauterine HBV infection.The fetus acquire passive immunization in intrauterine.Mothers with positive of HBsAg,HBeAg and HBcAg is a most important risk factor of intrauterine transmission.