乙型肝炎免疫球蛋白阻断HBV垂直传播的疗效观察

目的 观察评价外源性注射乙型肝炎免疫球蛋白(HBIG)对HBV母婴垂直传播的阻断效果和安全性.方法 选取2006年7月-2007年7月在我院产前检查和分娩的HBsAg阳性孕妇200例作为研究对象,根据知情同意原则,分为3组.A组:同意孕期及产后注射HBIG者75例;B组:同意产后注射HBIG者85例;C组:不同意或因经济原因无法注射HBIG者40例.凡新生儿HBV DNA阳性,即表示胎儿宫内感染HBV;婴儿出生后6个月HBV DNA阳性,亦表示垂直传播HBV.结果 孕28周时孕妇HBV标志物各指标检测结果3组间比较,差异无统计学意义(P>0.05),而A组经过产前3次HBIG注射之后,HBsAg、HBeAg、抗-HBs阳性率与B组和C组间比较,差异有统计学意义(P<0.01,P<0.05).3组孕妇在孕28周和产前血清中的HBV DNA阳性率间比较,差异无统计学意义(P>0.05);3组产后乳汁中HBV DNA阳性率间比较,差异有统计学意义(P<0.05,P<0.01).新生儿和6个月婴儿HBV感染率A组

Study on the preventive effect of hepatitis B immunoglobulin for the hepatitis B virus vertical transmission

Objective To observe the preventive effect of hepatitis B immunoglobulin (HBIG) for the HBV mother-infant vertical transmission.Method 200 HBsAg( + ) pregnant women were divided into three groups according to their will.Pregnant women in group A (n=75) were given HBIG since pregnancy 28 weeks and within 24 hours after parturition, besides their newborns. Pregnant women in group B (n = 85) were injected HBIG within 24 hours after partu-rition. Pregnant women in group C (n = 40) didn't take HBIG. Newborns in three groups were all taken HBV vaccine. Mather-infant vertical transmission standards: HBV DNA was positive either within 24 hours or six months after parturi-tion.Results The positive rates of HBsAg, anti-HBs, HBeAg, anti-HBe and anti-HBc had no statistical difference in pregnancy 28 weeks mothers' serum( P > 0.05). After injected HBIG three times, group A had different positive rates of HBsAg, HBeAg and anti-HBs, compared with those in other two groups( P < 0.05, P < 0.01 ). The HBV DNA positive rates in milk had statistical difference between three groups( P < 0.05, P < 0.01) .The HBV infection rates of newborns and six month infants were group A < B < C( P < 0.05, P < 0.01). Conclusions HBIG intramuscular injection has obvi-ously preventive effect for the HBV mother-infant vertical transmission, and may decrease the risk of infection by maternal breast-fed.