阻断乙型肝炎病毒父婴传播的研究

目的探讨阻断乙型肝炎（乙肝）病毒父婴垂直传播的有效方法。方法将在北京市海淀区妇幼保健院乙肝母婴阻断门诊就诊的配偶为HBV携带者的孕妇共例61例作为观察对象，22例配偶为乙肝表面抗原和乙肝e抗原双阳性及乙肝病毒脱氧核糖核酸阳性。其中28例孕妇也为乙肝病毒携带者，仅1例孕妇为HBsAg和HBeAg双阳性。对33例本人未检出HBV抗原的孕妇检测乙肝表面抗体定量，对定量较低或阴性的孕妇在孕前或孕期接种国产（基因重组酵母）乙肝疫苗10μg，根据定量接种1—2次。对孕妇也为HBV携带者和孕妇在孕末期前检验血中尚未达到高滴定度保护性抗体乙肝表面抗体者，在孕末期28、32、36w各肌肉注射乙肝免疫球蛋白400IU。观察新生儿生后12h内静脉血乙肝表面抗原和乙肝e抗原及乙肝表面抗体定性，采用酶联免疫法定性测定。结果所有观察新生儿61例生后12h内静脉血乙肝表面抗原和乙肝e抗原均为阴性，以后3、6、12个月复查乙肝表面抗原和乙肝e抗原未发现阳转者。33例母亲未检出HBV的新生儿生后12h内静脉血乙肝保护性抗体乙肝表面抗体均为阳性，28例母亲也为乙肝病毒携带者的新生儿乙肝表面抗体均为阴性。结论对配偶为乙肝病毒携带者的孕妇在孕前或孕期接种乙肝疫苗；对孕妇也为HBV携带者或孕妇在孕末期前检验血中尚未达到高滴定度保护性抗体乙肝表面抗体者，在孕末期肌肉注射较大剂量乙肝免疫球蛋白的措施可基本阻断乙肝病毒父婴垂直传播。

A study of interrupting the hepatitis B virus from father to infant vertical transmission

Objective ： To study the effective method of the interrupting father to the infant the hepatitis B virus （HBV） vertical transmission. Methods： 61 pregnant woman whose husband was the HBV carrier were observed, in the their husband there were 22 cases whose the hepatitis B superficial antigen （HBsAg） and the hepatitis B e antigen （HBeAg） and the hepatitis B virus DNA were positive all, in them there were 28 pregnant woman was the HBV carrier too. 33 pregnant woman whose HBV was negative were test the titer of the hepatitis B superficial antibody （HBsAb）. The pregnant woman whose the titer HBsAb was lower or negative were inoculated the hepatitis B vaccine （HBvas） 10μg and repeatedly 1 or 2 times according the titer HBsAb. The titer HBsAb of the pregnant woman was still lower at pregnant later period or themselves also was the HBV carrier was injected HBIG 400 IU at pregnant 28 and 32 and 36 weeks respectively. The HBsAg and HBeAg and HBsAb of the neonates were observed. Result： Within 12 hour after birth the HBsAg and HBeAg of the neonates vein blood all was negative and no one become positive in retest at 3, 6, 12 month after birth, 33 neonates whose mother HBV was negative the HBsAb was positive all, 28 neonates whose mother also was the HBV carrier the HBsAb was negative all. Conclusion： The method that is the active immunity （HBvas） or the passive immunity （HBIG） make the pregnant woman whose husband is the HBV carrier have enough the immunity protective antibody HBsAb may interrupt the HBV vertical transmission from father to the infant.