联合免疫预防乙型肝炎病毒宫内感染106例临床观察

目的:探讨孕妇主动与被动联合免疫乙型肝炎病毒(HBV)宫内感染的作用和机理。方法:将106例HBsAg( )孕妇分成两组,预防组60例,自孕妇20周起多次注射乙肝疫苗(HBVac)和乙肝免疫球蛋白(HB IG);对照组46例,不用HBVac和HB IG。母婴血清HBsAg、HBeAg和HBs用固相放免法检测,HBV-DNA用有套式PCR检测。结果:预防组新生儿血清HBsAg和HBV-DNA检出率明显低于对照组(3.3%)与26.1,10%与34.8%)均<0.05;预防组新生儿抗-HBs阳性率显著高于对照组(33.3%与8.7%)P<0.05。结论:孕妇于孕期通过HB IG和HBVac免疫,可有效预防HBV宫内感染,其机理可能为胎儿获得被动免疫。

Clinical Observation on Combination Immunization in Preventing Intrauterine HBV Infection

Objective:To study the efficacy and possible mechanism of active and passive immunization during pregnancy in preventing intrauterine HBV infection.Method:Fifty three pregnant women with HBsAg positive were devided into two groups.In the prevention group,60 cases were injected with hepatitis B vaccine(HBVac)and hepatitis B immunoglobulin(HBIG) during pregnancy since the 20thweek of gestation) In the control group,46 cases without injec-tion of HBVac or HBIG.HBsAg,HbeAg and anti-HBs were tested with solid phase radio immunoassay and HBV-DNA in serum was detected with nested polymerase chain reaction in maternal and neonates.Result:The detection rate of the HBsAg and HBV-DNA in the newborns of prevention group was signif-icantly lower than that of the control group(3.3% vs26.1%,10%vs34.8%,P<0.05,respectively);the detection rate of anti-HBs was significantly high-er in the newborns of the prevention group that that of the control group(33.3%vs8.7% P<0.05).Conclusion:Immunization with HBVac and HBIG during pregnancy may prevent intrauterine HBV infection effectively and its mechanism may be that the fetuses acquire passive immunization.