不同剂量HBIG对母婴乙型肝炎病毒抗原抗体宫内传播的影响

目的探讨不同剂量乙肝免疫球蛋白（HBIG）对乙型肝炎病毒（HBV）抗原抗体宫内传播的影响。方法将母亲乙肝表面抗原（HBsAg）阳性的婴儿作为500例观察对象,根据出生前母亲是否用HBIG分为：观察1组：产前母亲孕末期28w、32w、36w各用200IU（蓉生）HBIG 200例;观察2组：产前母亲孕末期28w、32w、36w各用400IU（蓉生）HBIG 100例;对照1组：产前母亲孕末期不用HBIG 200例。观察生后12h内新生儿静脉血乙肝五项：HBsAg、乙型肝炎表面抗体（HBsAb）、乙型肝炎e抗原（HBeAg）、乙型肝炎e抗体（HBeAb）、乙型肝炎核心抗体（HBcAb）。结果观察1组200例新生儿HBsAg阳性1例,阳性率为0.5%,HBeAg阳性3例,（其中1例HBsAg同时阳性）阳性率为1.5%。对照组HBsAg阳性2例,阳性率为1%,HBeAg阳性8例,（其中2例HBsAg同时阳性）阳性率为4%。经统计学处理（HBsAg）χ2=0.336,P=0.562;（HBeAg）,χ2=2.337,P=0.126。观察1组与对照组生后24h内HBV抗原检测比较无显著差异。观察1组、观察2组与对照组HBsAb检测比较：观察1组新生儿HBsAb阳性率1%,观察2组新生儿HBsAb阳性率2%,对照组HBsAb阳性率1%,各组HBeAb和HBcAb检测比较,结果HBeAb和HBcAb检测母婴符合率均在97%-97.5%之间。结论孕妇HBV携带者产前孕末期用HBIG 200IU隔4w连用3次的方法对阻断乙肝病毒的宫内感染效果不显著。加大HBIG的用量400IU可基本阻断HBV垂直传播胎儿。但鉴于对照组宫内感染率仅4%,加大用量不适用所有HBV携带者孕妇,尤其是HBsAg单阳性孕妇。

A contrast study for the effect of difference dose of the Hepatitis B immunity globulin to interrupting the Hepatitis B virus antigen and antibody inner-uterus transmit from mother to infants

Objective： To study for the effect difference dose of Hepatitis B immunity globulin （HBIG） to interrupting the Hepatitis B Virus （HBV） antigen and antibody transmit from mother to infants. Methods- 500 neonates whose mothers were the hepatitis B superficial antigen （HBsAg） positive were observed. They were divide into the observed I group and the observed 11 group and the control I group. In the observed I group 200 cases pregnant mother Was injected （Ronsen） HBIG 200 IU at pregnant 28 and 32 and 36 weeks respectively. In the observed II group 100 cases pregnant mother Was injected HBIG 400 IU at pregnant 28 and 32 and 36 weeks respectively. In the observed I group 200 cases pregnant mother was not injected HBIG. The HBsAg and The hepatitis B superfieial antibody （HBsAb） and the hepatitis B e antigen （HBeAg） and the hepatitis B e antibody （HBeAb） and The hepatitis B core antibody （HBeAb） of the neonates vein blood were observed within 12 hour after birth. Results： （ 1 ） To examined the hepatitis B an- tigen： In the observed I group, the HBsAg positive rate was 0. 5% , the HBeAg positive rate was 1. 5% , In observed I group the HBsAg positive rate was 1% , the HBeAg positive rate was 4% , （HBsAg） χ^2 = 0. 336, P =0. 562 ; （ HBeAg）,χ^2 = 2. 337, P = 0. 126. In the observed II group no one the HBsAg and the HBeAg is positive. The examining the HBsAb： in the observing I group the HBsAb positive rate was 1%, in the observed 1I group it was 2%, in the control group it was 1%. In the every group the accord rate of the HBeAb and the HBcAb of the neonates with mother were 97% -97.5%. Conclusion： Above result prove general dose the HBIG was not marked efficacy to interrupting the Hepatitis B Virus inner - uterus infection from Mother to infants. To increasing dose of the HBIG should be necessary. Whereas in the control group the inner - uterus infection rate only was 4%, to increasing dose of the HBIG is inapplicability most pregnant woman who is Hepatitis B Virus sup