乙肝疫苗与乙肝免疫球蛋白联用阻断HBV母婴传播

目的研究乙型肝炎免疫球蛋白（HBIG）联合乙肝疫苗阻断母婴传播的效果。方法88例HBs缸阳性孕妇随机分为实验组45例和对照组43例。实验组自28周开始每月肌肉注射一次乙肝免疫球旦白（HBIC）200U直至分娩，对照组不用上述药物。实验组孕妇所分娩婴儿出生后行被动一主动联合免疫，对照纽孕妇所分娩婴儿出生后行主动免疫。两组婴儿12月龄时采静脉血测乙型肝炎病毒标志物。结果实验组婴儿HBsAg慢性携带率为4．44％，明显低于对照组（20．93％），P〈0．025；经两种免疫干预1年后，实验组婴儿血清抗-HBs阳转率达93．33％，明显高于对照组（76．74％），P〈0．05。结论孕妇产前多次注射HBIG能有效减少HBV宫内感染，且使出生后婴儿血清抗体阳性率明显增高；新生儿单用乙肝疫苗对产时感染的阻断不完全，HBIG联合乙肝疫苗可明显提高产时感染的阻断效果。

Observation of Effect of Hapatitis B Vaccine Single Use and Combination Use with HBIG in Blocking HBV Mother - infant Transmission

Objective To study the effect of HBIG combined with HB immune in blocking mother-infant transmssion.Methods 88 cases with HBsAg positive gravida were divided into experiment group (45 csses) and control group (43 cases) randomly.Experiment group were infected HBIC (200 IU) im once a month since 28th week untill parturation,the above drug were not used in the control group.The infants of experiment group were conducted passive-active combination immunity, that of control group were conducted active immunity.The HBV marker of venous blood of the infants in the two groups was checked at 12 month old.Results The HBsAg carriage rate of infants of experiment group was 4.44%,which is obviously lower than that of control group (20.93%) ,P<0.025;After 1 year's interference of the two immunity the serum anti-HBs positive transfering rate of experiment group reached 93.33%,which is obviously higher than that of control group (76.74%),P<0.05.Conclusion The multi-times injection of HBIG before patruration can effectively reduce HBV intrauterus infection,and HBIG and hepatitis B vaccine can obviousby increase the blocking effect make the infant's serum antibody positive rate increase obviously.