乙肝表面抗原阳性孕妇肌肉注射乙肝免疫球蛋白预防母婴传播

目的探讨经母亲对胎儿行被动免疫在预防乙型肝炎病毒(HBV)宫内感染中的作用。方法对自孕28周起多次肌肉注射乙肝免疫球蛋白(HBIG)的HBsAg阴性孕妇40例(A组)及未注射的16例(B组),用酶联免疫吸附试验(ELISA)和套式PCR检测母血HBsAg、HBVDNA及新生儿血HBsAg、抗-HBs、HBVDNA。结果A组40例新生儿中37例血清抗-HBs阳性,与B组相比差异有统计学意义(P<0.01)。A组新生儿血HBsAg、HBVDNA检出率明显低于B组。A组孕妇用药后血HBsAg滴度及HBVDNA水平较用药前明显下降。结论经母亲对胎儿行被动免疫可有效预防HBV宫内感染。

Prevention of HBV Transmission from Mother to Infant by Injecting HBIG to Pregnant Women with Positive HBsAg

Objective To investigate the effect of passive immunization of fetus by injection of HBIG to mothers for prevention of HBV intrauterine infection. Methods Fifty-six pregnant women with positive HBsAg were divided into two groups: group A(40 cases) was injected with HBIG for many times since 28 weeks after pregnancy; group B(16 cases) was followed up without injection of HBIG as control. The blood samples of mothers and their infants were tested with ELISA and PCR. Results Among 40 infants in group A, 37 (92.5%) were positive for anti-HBs, while 2 infants in group B (12.5%) were positive for anti-HBs (P<0.01).The infants with HBsAg positive and HBV DNA positive in group A were fewer than those in group B. The tite of HBsAg and level of HBV DNA were obviously descended after injection among pregnant women in group A. Conclusion Passive immunization of fetus by injection to mother with HBsAg may prevent HBV intrauterine infection effectively.