孕期注射乙肝免疫球蛋白阻断宫内与胎盘感染的相关性研究

目的探讨HBsAg阳性孕妇孕期注射乙肝免疫球蛋白（HBIG）阻断母婴传播的疗效与胎盘HBV感染之间的相关性。方法92例HBsAg阳性孕妇分成两组，研究组44例，于妊娠28、32及36周肌注HBIG 200IU；对照组48例，未用药。采用荧光定量PCR及ELISA法．分别检测孕妇及其新生儿静脉血HBVDNA水平及乙肝五项。采用免疫组化S—P法，检测胎盘各层细胞HBsAg及HBcAg的表达。结果（1）92例孕妇胎盘HBV感染43例，各层细胞感染后导致官内传播的相对危险度（OR值）由母面至胎儿面呈逐渐上升趋势。（2）研究组胎盘HBV总的感染率为34．09％（15/44）．而对照组为58-33％，两组比较，差异有显著性（P〈0．05）。（3）研究组胎盘VCEC感染：率为6．82％（3／44），而对照组为27．08％（13／48）。两组比较，差异有显著性（P〈0．05）。结论（1）胎盘VCECHBV感染是官内感染的高危因素之一。（2）注射HBIG可降低胎盘HBV感染率。

Relationship between the effect interrupting mother-to-infant transmission by injected HBIG to pregnant women and placenta hepatitis B virus infection

Objective To study the relationship between the effect interrupting of HBsAg positive mothers injected HBIG and placenta hepatitis B virus infection Methods ELISA and PCR were used for detection of HBV infection markers of serums.S-P immunohistochemical straining with monoclonal anti-HBs and anti-HBc antibodies was used for detection of HBsAg and HBcAg placenta.Results(1)The positive rates of placenta were a gradually decrease of HBV infection from maternal side to fetal side of placenta.There were an increase trend of the OR from maternal side to fetal side of placenta.(2)The total HBV infection rates of placenta among the study group was 34.09%(15/44),which was significantly lower than that of the control group(58.33%).(3)The placenta VCEC infection rate of the study group 7.31%(3/44) was significantly lower than that of control group 37.14%(13/48)(P<0.05).Conclusion(1) The placenta VCEC HBV infection is one of the risk factor of HBV intrauterine infection.(2)The placenta HBV infection rate can be reduced by HBIG passive immunization of pregnant women.