乙型肝炎病毒感染母亲的新生儿免疫预防后远期保护效果

目的:探讨母亲感染乙型肝炎病毒(HBV)后,新生儿免疫预防措施及远期保护效果。方法:选择2013年1月至2014年12月定期产检并顺利分娩的240例HBV感染孕产妇及其新生儿(240例)作为研究对象。将接受免疫预防措施的120例孕产妇及其新生儿作为观察组,将未接受免疫预防措施的120例孕产妇及其新生儿作为对照组。比较2组新生儿HBV感染率,出生时、出生1年后乙型肝炎表面抗体(HBsAb)阳性率。随访5年,根据新生儿免疫预防效果,将母亲分为免疫成功组和失败组,分析影响免疫预防效果的因素。结果:观察组新生儿HBV感染率为0,低于对照组的16.67%(P0.05);出生时、出生1年后,观察组新生儿HBsAb阳性率分别为22.50%、96.67%,高于对照组(5.00%、78.33%,P0.001);观察组5年内加强接种乙肝疫苗率为26.67%,低于对照组(55.00%,P0.001)。免疫成功组与失败组母亲血清乙型肝炎病毒e抗原(HBeAg)滴度、HBV-DNA浓度、是否使用抗病毒药物、病毒变异情况差异均有统计学意义(P0.05)。结论:同时给予HBV感染孕产妇及其新生儿乙型肝炎免疫球蛋白(HBIg)、乙肝疫苗预防HBV母婴传播,可有效降低新生儿感染HBV风险,提高HBsAb阳性率,获得远期保护效果。

Long-term protection effects of newborn's immunoprophylaxis in hepatitis B virus-infected mothers

Objective: To discuss the newborn''s immune-prophylaxis and long-term protection effects when their mothers were infected with hepatitis B virus (HBV). Methods: A total of 240 HBV-infected pregnant women (240 newborns) taking the antenatal care and delivered between January 2013 and December 2014 were selected as research subjects. Totally, 120 pregnant women and newborns taking the prevention measures were included as the observation group; 120 pregnant women and newborns without taking the prevention measures were included as the control group. The HBV infection rate and hepatitis B surface antibody (HBsAb) positive rate at birth and one year after birth were compared between the two groups. After 5 years of follow-up, according to the effect of neonatal immunization, mothers were divided into success group and failure group. Results: HBV infection rate in newborns of the observation group (0%) was significantly lower than that in newborns of the control group (16.67%, P<0.05). At birth and 1 year after birth, HBsAb positive rates in newborns of the observation group was significantly higher than those in newborns of the control group (22.50% vs 5.00% and 96.67% vs 78.33% respectively, P<0.05); within 5 year of birth, the rate of inoculating hepatitis B vaccine in the observation group (26.67%) was significantly lower than that in the control group (55.00%, P<0.05). Mother''s serum hepatitis B virus e-antigen (HBeAg) titer, HBV-DNA concentrations, antiviral drug dosage and virus variation were closely correlated with immune-prophylaxis effects in newborns. Conclusions: For HBV-infected pregnant women and newborns, hepatitis B immunoglobulin (HBIg) and hepatitis B vaccine injection meanwhile can prevent mother-to-child transmission, and reduce HBV infection risks and increase positive rate of HBsAb, then produce the long-term immune-prophylaxis effects in newborns.