不同方法阻断乙型肝炎病毒母婴垂直传播的临床观察

目的 探讨阻断乙型肝炎病毒母婴垂直传播的方法。方法 将94例HBsAg阳性孕妇分成4组，单纯HBVac治疗组29例，单纯HBIG治疗组19例，左旋咪唑涂布剂加两者联合应用13例，未治疗组33例，均在孕26周起开始注射，孕妇和新生儿血清HBsAg，抗－HBs,HBeAg，抗－HBe，抗－HBc检测采用ELISA法。94例孕妇按分娩方式不同分别观察对乙肝病毒母婴传播的影响。结果 脐血中HBsAg阳性率，HBVac治疗组为17．24％，HBIG治疗组为5．26％，联合治疗组为0，未治疗组为21．21％。在不同的分娩方式中，急症剖宫产新生儿脐血HBsAg阳性率为0，行择期剖宫产者为10．5％，经阴道分娩者为16．9％。结论 携带HBV孕妇于孕晚期给予HBVac，HBIG和左旋咪唑涂布剂联合两者治疗后，可有效阻断HBV母婴之间传播，以联合治疗组效果最佳，剖宫产术有助于阻断HBV母婴传播。

Clinical Study on Prevent Mother infant Vertical Transmission of Hepatitis B Virus Using Different Methods

Objective To probe into prevent methods on mother infant vertical transmission of hepatitis B virus.Method Ninety four chronic HBsAg carriers pregnant women were divided into four groups.29 cases were injected with hepatitis B vaccine,19 cases were injected with hepatitis B immunoglobulin;13 cases were injected combined with both add levamisole liniment during pregnancy since the 26th week of gestation;there were 33 cases without injection of HBVac or HBIG and other.Serologic HBV mothers (HBsAg,HBsAb,HBeAg,HBeAb,HBcAb) of pregnant women and newborns umbilical blood were detected by ELISA.These women were divided into two groups by delivery manier. Result HBsAg positive rate of newborns umbilical blood were 17.24%,5.26% and 0 with different treatments(HBVac,HBIG,HBVac and HBIG add levamisole liniment),respectively.By different delivery manier,infection rate of emergent caesarean section,selected caesarean section and vaginal delivery were 0,10.5% and 16.9%,respectively.Conclusion Immunization with HBVac or HBIG or both add levamisole liniment during pregnany may prevent intrauterine HBV infection effectively.In order to decrease transmission of mother infant,caesarean section birth showed be adopted.