乙肝病毒宫内感染与孕期乙肝免疫球蛋白的临床应用研究

目的 :探讨孕妇乙肝病毒感染 (HBV)与胎儿宫内感染的关系 ,以及孕期注射乙肝免疫球蛋白的临床应用价值。方法 :应用逆转录聚合酶链反应法 (PCR)定性检测 2 0 0例大、小三阳的孕妇血清、乳汁 HBV-DNA,对 HBV-DNA阳性者孕 3月起 ,1次 /月肌注乙肝免疫球蛋白 2 0 0 U,直至分娩 ,分娩后 2 4h内 ,取新生儿末梢静脉血进行 HBV-DNA定性测定。结果 :10 0例大三阳孕妇血清 HBV-DNA阳性率为 86% ,10 0例小三阳孕妇血清 HBV-DNA阳性率为 3 6% ,两者相比 ,有显著性差异 (P<0 .0 0 5) ;孕妇血清 HBV-DNA阳性者 ,其宫内感染率为 2 2 .95% ,孕妇血清阴性者 ,其宫内感染率为 5.13 % ,两者相比 ,有显著性差异 (P<0 .0 0 5) ;孕妇血清 HBV-DNA阳性者 ,其乳汁 HBV-DNA阳性率为 16.3 9%。孕期注射乙肝免疫球蛋白可阻断宫内传播。结论 :孕妇乙肝病毒感染可导致胎儿宫内感染 ,HBV-DNA阳性孕妇具有更强的传染性 ,孕期注射乙肝免疫球蛋白可减少胎儿乙肝病毒感染

Study about intrauterine Hepatitis B Virus infection and clinical application of HBIg during pregnant period

Objective: To study the relationship between hepatitis B virus infected pregnant women and intrauterine infection of their fetuses,and its clinical value of HBIg passi ve immunization of pregnant women Methods:HBV-DNA in serum and milk were determined using P CR method in 200 HBsAg positive pregnant women, and those HBV-DNA positive were given HBIg passive immunization 200 U per month since their three months pregna cy to delivery And HBV-DNA in the new born's serum was determined within 24 h ours after delivery Results:The HBV-DNA positive rate in 100 pregnant women w ho were HBsAg+、HBeAg+、anti-HBc+ and 100 HBsAg+、anti-HBe、anti-HBc+is 86% a nd 36% The two has significant difference The rate of intrauterine infection in HBV-DNA positive pregnant women is 22 95%, and 5 13% in those HBV-DNA ne gative The two has significant difference the positive rate of HBV-DNA in m ilk is 16 39% in HBV-DNA positive pregnant women The intrauterine infectio n can be retarded by HBIG passive immunization Conclusion:The infection of HBV in pregnant women can lead to intrauterine infection of their fetuses The HBV-DNA positive pregnant wome n have stronger infective abilities Fetal intrauterine HBV can be reduced by HB Ig passive immunization of pregnant women