孕前抗病毒治疗阻断乙型肝炎病毒母婴传播的效果

目的探讨孕前抗病毒治疗在阻断母婴传播中的作用。方法将136例HBsAg（＋）孕妇分成3组，治疗组孕前用拉米夫定100mg／d抗病毒治疗3个月，停药1个月后怀孕，孕后第4-9个月每月给孕妇肌内注射乙肝免疫球蛋白（HBIG）200U；对照组孕前不治疗，孕后28、32、36周各肌内注射HBIG 200U，两组婴儿出生后24h和2周各注射HBIG 200U，1个月始按免疫程序注射乙肝疫苗（HBVac）。疫苗组只按乙肝疫苗免疫程序给婴儿注射乙肝疫苗。血清检测HBVM采用ELISA法。结果治疗组、对照组和疫苗组12个月龄婴儿抗-HBs阳性率分别为86．67％、75．61％和51．43％，HBsAg阳性人数分别为2、5和11例。结论孕前抗病毒治疗和早期应用HDIG可有效阻断母婴传播，降低患者的宫内感染率，提高免疫成功率。

Effect of Pregestational Anti-HBV Treatment on the Obstruction of Mother-infant Transmission of Hepatitis B Virus

Objective] To explore the effect of pregestational anti-HBV treatment on the obstruction of mother-infant transmission of hepatitis B virus.Methods] 136 pregnant women with positive HBsAg were divided into three groups.The treatment group received orailamivudine 100 mg/day for 3 months before pregnancy with one month in between,then the pregnant women were injected with HBIG at 16-week,20-week,24-week,28-week,32-week and 36-week during pregnancy.The control(HBIG) group received injection of HBIG at 28-week,32-week and 36-week during pregnancy only.The newborn babies in both groups were injected with HBIG and HB Vaccine after 24 hours,2-weeks and 1-month respectively.ELISA was adopted to test the HBVM in serum.Results] The anti-HBs positive rate of the 12-month babies in the treatment group,control group and vaccine group were 86.67%,75.61% and 51.41% respectively;2,5 and 11 cases were found with positive HBsAg respectively in the three groups.Conclusion] Pregestational anti-HBV treatment and early-stage injection with HBIG can effectively obstruct mother-infant transmission of GBV and improve the success rate of immunization.