联合免疫有效降低乙肝病毒宫内传播的临床研究

目的研究母体对胎儿行被动免疫及出生后胎儿行主动免疫在降低乙型肝炎病毒(HBV)宫内感染中的作用。方法选择HBsAg( )的孕妇共60例,30例孕妇于孕28、32、36周分别肌注高效乙肝免疫球蛋白(HBIG)各200U为试验组;对照组为未注射HBIG的30例HBsAg( )的孕妇。用ELISA和PCR方法检测母血及脐血、新生儿血中HBV标志物及HBV-DNA。结果试验组31例新生儿中血清抗-HBs( )29例,对照组5例抗-HBs( ),两者相比有显著差异(P<0.05)。前者新生儿血HBsAg,HBV-DNA检出率明显低于后者。孕妇用药后HBsAg滴度及HBV-DNA水平较用药前明显下降。结论联合免疫能有效降低HBV宫内传播,减少宫内感染的发生。

Combinating immunity can effectively decrease intrauterine transmission and intrauterine infection of B type of hepatitis virus

Objective To observe the effect of passive immunity to fetus from mother and vaccined after birth on HBV intrauterine infection. Methods 60 cases of pregnancy women with HBsAg( ) were included.30 cases were in study group who accepted HBIG during 28w,32w,36w of pregnancy;other 30 cases didn't accept HBIG. We evaluated the HBV markers and HBV-DNA of mothers' serum, cord blood and newborn serum. Results The anti-HBs were positive in 29 cases of newborn's serum ,while in control group,only 5 cases were positive. There was significant difference between two groups(P<0.05). The positive incidence of HBsAg,HBV-DNA in study group is apparently lower than that in control group. The level of HBsAg and HBV-DNA in study group after injection HBIG is apparently decreased than before. Conclusion Combinating immunity can effectively decrease intrauterine transmission of HBV,decrease intrauterine infection.