太原市HBsAg阳性孕妇注射HBIG与HBV宫内感染关系的研究

目的:探讨太原市乙肝病毒不同感染状态的HBsAg阳性孕妇孕晚期注射乙肝高效价免疫球蛋白(HBIG)的参考指标,分析依据参考指标下注射HBIG与HBV宫内感染的关系。方法:以太原市传染病医院产前检查并分娩的HBsAg阳性孕妇为研究对象,收集其分娩前HBIG的注射史、乙肝病毒标志物以及新生儿24 h内的乙肝标志物的资料。分别以HBeAg、HBVDNA两种病毒复制指标为分组指标将278例HBsAg阳性孕妇分组,分析组间HBIG注射的差异,进而分别以HBeAg、HBV DNA为分层因素分析孕晚期注射不同剂量HBIG和新生儿宫内感染的关系。结果:HBsAg阳性孕妇母亲HBV DNA组与HBV DNA阴性组注射HBIG的差异具有统计学意义(x~2=25.639,P=0.000),而孕妇母亲HBeAg阳性组和HBeAg阴性组注射HBIG的差异无统计学意义(x~2=4.627,P=0.099);两个参考指标组内注射HBIG与新生儿宫内感染均无关联。结论:太原市HBsAg阳性孕妇孕晚期以孕妇HBV DNA阳性作为是否注射HBIG的参考指标,孕晚期注射HBIG不能阻断新生儿发生HBV宫内感染。

Investigation on relationship between HBIG injection of pregnant women with positive HBsAg and intrauterine infection of HBV in Taiyuan

Objective:To explore the reference indexes of hepatitis B immunoglobulin(HBIG) injection and the relationship between immunological effect of HBIG injection and maternal-infant transmission among HBsAg positive pregnant women with different HBV carrier status.Methods:Pregnant women with positive HBsAg in Taiyuan were selected.Data of HB1G infection history,markers of HBV of pregnant women and neonates at birth within 24 hours were collected.278 HBsAg-positive pregnant women were divided into different groups by means of HBeAg and HBV DNA.The difference of HBIG injection were analyzed between each group,then the relationship between immunological effect of HBIG injection and intrauterine infection of neonates was analyzed by stratification factors which were HBeAg and HBV DNA.Results:There was significant difference in immunological effect of HBIG injection between positive HBV DNA group and negative HBV DNA group(x~2=25.639,P=0.000),but there was no significant difference in immunological effect of HBIG injection between positive HBeAg group and negative HBeAg group(x~2=4.627,P=0.099).There was no correlation between HBIG injection and neonatal intrauterine infection of HBV.Conclusion:The reference index of HBIG injection is HBV DNA but not HBeAg among HBsAg-positive pregnant women in Taiyuan,the protective effect of HBIG on HBV intrauterine infection is not found.