乙肝疫苗联合乙型肝炎免疫球蛋白接种阻断血清HBsAg阳性母亲HBV母婴传播效果分析*

目的 分析乙肝疫苗联合乙型肝炎免疫球蛋白（HBIG）接种阻断血清HBsAg阳性母亲乙型肝炎病毒（HBV）母婴垂直传播的效果。方法 在血清HBsAg阳性母亲所分娩的712例新生儿中,356例接受标准乙肝疫苗,另356例在接种乙肝疫苗的同时,接受 HBIG接种,比较1~10岁儿童接种成功率和HBV母婴垂直传播阻断率。结果 在56例1~2岁、234例3~4岁、249例5~6岁、135例7~8岁和38例9~10岁年龄组儿童,血清抗-HBs阳性率分别为89.3%、87.6%、81.1%、83.7%和76.3%,HBsAg阳性率分别为0.0%、0.4%、0.4%、1.5%和2.6%,各年龄组比较,无显著性统计学差异（P>0.05）;联合接种与乙肝疫苗接种组血清抗-HBs阳性率分别为84.3%和64.3%,血清HBsAg阳性率分别3.1%和15.2%,两组差异显著（P<0.05）;在血清HBsAg/HBeAg双阳性母亲所分娩的儿童,246例联合接种组血清HBsAg阳性率为1.6%,显著低于162例只接种乙肝疫苗组的11.7%（P<0.05）,而在血清HBsAg阳性母亲所分娩的儿童,110例联合接种与194例只接种乙肝疫苗组比,血清HBsAg阳性率无显著性差异（2.7%对6.2%,P>0.05）。结论 对血清HBsAg/HBeAg双阳性母亲所分娩的新生儿,给予乙肝疫苗联合HBIG接种可能更有效地阻断HBV母婴垂直传播。

Efficacy of combination inoculation of hepatitis B vaccine and hepatitis B immunoglobulin on blocking mother-to-child transmission of hepatitis B virus infection in newborn with serum HBsAg/HBeAg-positive mothers

Objective To investigate the efficacy of combination inoculation of hepatitis B vaccine and hepatitis B immunoglobulin（HBIG） on blocking mother-to-child transmission of hepatitis B virus infection in newborn with serum HBsAg/HBeAg-positive mothers. Methods 712 newborns with serum HBsAg（n=304） or HBsAg/HBeAg-positive （n=408） mothers were inoculated with hepatitis B vaccine （n=356） or hepatitis B vaccine and HBIG combination（n=356）. The children were followed-up for ten years. Results Serum anti-HBs positive rates were 89.3%,87.6%,81.1%,83.7% and 76.3% in 56 children at age of 1-2 yr,234 at of 3-4 yr,249 at of 5-6 yr,135 at of 7-8 yr and 38 at of 9-10 yr,and serum HBsAg positive rates were 0.0%,0.4%,0.4%,1.5% and 2.6%,respectively,without significant differences among the five groups（P>0.05）;serum anti-HBs positive rate in combination inoculation group was 84.3%,much higher,while serum HBsAg positive rate was 3.1%,much lower than in hepatitis B vaccine inoculation group（64.3% and 15.2%,respectively,P<0.05）;in children with serum double HBsAg/HBeAg positive mothers,serum HBsAg positive rate in 246 children with combination inoculation was 1.6%,much lower than 11.7% （P<0.05） in 162 children with hepatitis B vaccine inoculation alone,while in children with serum HBsAg positive mothers,there was no significant difference as respect to their serum HBsAg positive rates（2.7% vs. 6.2%,P>0.05） in 110 children with combination and 194 with hepatitis B vaccine inoculation. Conclusions The hepatitis B vaccine combined with HBIG inoculation in newborns with serum double HBsAg/HBeAg positive mothers might block HBV mother to child transmission,which is worthy of clinical observation.