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乙型肝炎免疫球蛋白阻断乙型肝炎母婴垂直传播的研究
引用本文:廖戎,彭瑞宇.乙型肝炎免疫球蛋白阻断乙型肝炎母婴垂直传播的研究[J].中国计划生育学杂志,2009,17(10):619-621.
作者姓名:廖戎  彭瑞宇
作者单位:1. 云南省人口和计划生育科学技术研究所,昆明,650021
2. 昆明市第三人民医院
摘    要:目的:评价乙型肝炎免疫球蛋白(HBIG)阻断乙肝病毒e抗原(HBeAg)和乙型肝炎表面抗原(HBsAg)阳性孕产妇乙型肝炎病毒(HBV)母婴垂直传播的效果。方法:102例HBeAg和HBsAg阳性孕产妇纳入研究,60例妊娠28周前检测出HBeAg和HBsAg阳性的孕产妇为研究组,42例临产前入院HBeAg和HBsAg检测阳性的孕产妇为对照组。研究组从妊娠28周开始一次性肌注HBIG200U,每间隔4周肌注1次,共3次。对照组未进行HBIG注射。胎儿娩出后立即收集脐静脉血进行HBeAg和HBV—DNA检测。结果:研究组60例新生儿中,有5例HBeAg阳性,阳性率为8.3%;7例HBV—DNA阳性,阳性率为11.7%,7例新生儿HBV—DNA病毒平均拷贝数(6.6×10^2 copies/m1)明显低于母亲(7.4×10^2 copies/ml),P〈0.05。对照组42例新生儿中,有30例HBeAg阳性,阳性率为71.4%;33例HBV—DNA阳性,阳性率为78.6%,33例新生儿HBV—DNA病毒平均拷贝数(7.0×10^2copies/m1)与母亲相似(7.2×10^2copies/m1)。研究组新生儿病毒平均拷贝数明显低于对照组。结论:从孕28周开始给予HBIG注射阻断HBV母婴传播是一种有效方法,临床上应对HBeAg阴性但HBV—DNA阳性的孕产妇给予HBIG注射以阻断母婴传播。

关 键 词:乙型肝炎  阻断  母婴垂直传播  乙肝免疫球蛋白

Prevention of Vertical Hepatitis B Transmission with Hepatitis B Immunoglobulin
Institution:Liao Rong, Peng Ruiyu. (Yunnan Population and Family Planning Research Institute, Key Laboratory for Research in Fertility Regulation and Eugenics of Minority Nationalities of Yunnan Province, Kunming 650021)
Abstract:Objective:To evaluate the efficacy of hepatitis B immunoglobulin (HBIG) for preventing transmission of hepatitis B virus (HBV) in pregnant women tested positive for hepatitis B e antigen (HBeAg) and hepatitis B surface antigen (HBsAg). Methods:One hundred and tow women tested positive for HBeAg and HBsAg were analyzed,60 of whom in the treatment group and 42 in the control group. Women in the treatment group received 200 U HBIG at the intervals of 4 weeks for 3 times from gestational week 28. Women in the control group were not given HBIG. The cord blood of all newborns was collected for testing HBeAg and HBV DNA. Results:In the treatment group,five newborns (8.3%) were tested HBeAg-positive,and seven newborns (11.7%) were HBV DNA-positive. The mean HBV DNA load of the newborns (6.6×102copies/ml) was lower than that of their mothers (7.4×102copies/ml). In the control group,thirty newborns (71.4%) were tested HBeAg-positive,and thirty-three newborns (78.6%) were HBV DNA-positive. The mean HBV DNA load of the newborns (7.0×102copies/ml) was equivalent to that of their mothers (7.2×102copies/ml). The mean HBV-DNA load of newborns in the treatment group was lower than that of the control group. Conclusion:It is effective to prevent vertical transmission of HBV with HBIG from gestational week 28 in pregnant women tested positive for HBeAg and HBsAg. Pregnant women with HBeAg-negative and HBV DNA-positive should use HBIG for prevention of HBV transmission.
Keywords:Hepatitis B virus  Prevention  Vertical transmission  Hepatitis B immunoglobulin
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