乙型肝炎病毒母婴传播阻断的实施现况研究

目的:了解近年乙型肝炎病毒母婴传播阻断措施的实施状况,为控制乙肝流行提供依据。方法:对武汉市江岸区2004年1月1日～2006年12月31日的乙型肝炎表面抗原(HBsAg)阳性孕妇进行筛选,采取入户调查或电话访谈的方式,对HBsAg阳性孕妇采取的产前和产后免疫阻断措施,分娩方式及喂养方式等情况进行调查。结果:158例HBsAg阳性孕妇采取的乙肝母婴传播阻断免疫方案有4种,其中孕妇孕期注射乙肝免疫球蛋白(HBIG)及婴儿出生后联合应用乙肝疫苗及乙肝免疫球蛋白有123例,占77.85%。158例婴儿中,有26例出生后只单纯接种乙肝疫苗而未联合注射HBIG。HBsAg阳性母亲有130例采取剖宫产分娩,其中因携带HBV行剖宫产占28.46%。82例婴儿为人工喂养,其中因母亲携带HBV行人工喂养占89.02%。结论:大多数HBsAg阳性孕妇采取了产前和产后联合免疫阻断措施,少部分婴儿出生后未注射HBIG,应进一步加强母亲为HB-sAg阳性的婴儿出生后联合免疫方法的应用。

Analysis on implementation status of interrupting maternal-infant transmission of hepatitis B virus

Objective:To investigate the implementation status of interrupting maternal-infant transmission of hepatitis B virus(HBV),provide foundation for controlling of hepatitis B.Methods:The pregnant women with positive hepatitis B surface(HBsAg) who from Jiang'an District of WuHan within 3 years(from 2004 to 2006) were selected.Their immunization measures,delivery modes,feeding modes were investigated by face-to-face interviews and telephone interviews.Results:A total of 158 pregnant women with positive HBsAg adopted 4 kinds of immunization programmes to interrupt maternal-infant transmission.The programme of 123 pregnant women(77.85%) was hepatitis B immunoglobulin(HBIG) injection of pregnant women and hepatitis B vaccine and HBIG injection of infants.26 infants received hepatitis B vaccine injection without HBIG injection after born.130 women adopted cesarean section and 82 infants received artificial feeding,28.46% of cesarean section and 89.02% of artificial feeding were attributable to the factor of HBV.Conclusion:Most mothers with positive HBsAg adopte prenatal and postpartum immunoprophylaxis to interrupt maternal-infant transmission.A small number of infants don't inject HBIG after born,the application of immunization method should be strengthened in infants whose mothers are HBsAg-positive.