乙肝免疫球蛋白阻断病毒母婴传播的效果观察

目的 :探讨高效价乙肝免疫球蛋白 (HBIG)阻断乙型肝炎病毒 (HBV)母婴传播的作用机理。方法 :将5 0例HBsAg阳性的孕妇随机分成两组 ,实验组 30例 ,分别自孕 2 8周、32周、及 36周肌肉注射HBIG2 0 0IU ,分娩后 2 4h内再注射HBIG 2 0 0IU 1次 ;对照组 2 0例 ,不用HBIG。两组孕妇所生婴儿均于出生后 2 4h内肌肉注射HBIG 10 0IU 1次 ,注射乙肝疫苗的时间和剂量均按正常婴儿的操作方案进行。母儿血清HBsAg ,HBeAg和抗 HBs用固相放免法检测 ,HBV DNA用荧光定量PCR检测。结果 :实验组婴儿血清HBsAg和HBV DNA检出率明显低于对照组 (P <0 .0 5 ) ;实验组婴儿抗 HBs阳性率显著高于对照组 (P <0 .0 5 )。结论 :孕妇于孕期多次注射HBIG进行被动免疫 ,可有效地阻断乙型肝炎病毒母婴传播 ,减少婴儿HBV感染率。

Effect of High Titer Hepatitis B Immunoglobulin that Interrupt Maternal-fetal Transmission of Hepatitis B Virus

Objective:To study the interrupting mechanism of hepatitis B immunogloblin(HBIG) in maternal fetal transmission of hepatitis B virus(HBV). Methods: Fifty pregnant women with positive serum hepatitis B surface antigen(HBsAg) were randomly divided into two groups.30 cases in the HBIG group received 200 IU of HBIG intramuscularly at 28th,32th,36th weeks of pregnancy and within 24 hours afetr delivery, respectively.The other 20 cases in the control group were not given HBIG.All newborns of the 2 groups received 100*#IU of HNIG intramuscularly whithin 24 hours after birth, and were immunized with three doses of hepatitis B vaccine within 24 hours after birth,one month and six months of age,respectively. Serum HBsAg,hepatitis Be antigen (HBeAg) and hepatitis B suface antibody (Anti HBs) in all pregnant women and infants were detected with solid phase radioimmunoassay(SPRIA),and hepatitis B virus DNA (HBV DNA) was detected with fluorescence quantitative polymerase chain reaction(FQ PCR). Results: Serum HBsAg and HBV DNA positive rates of infants in the HBIG group were greatly lower than that of control group (P<0.05);Anti HBs positive rates of infants in the HBIG group were significantly higher than that of control group (P<0.05). Conclusion: Administration of multiple HBIG intramuscularly during pregnancy is a passive immunoprophylaxis method for pregnant woman.The method can efficiently ineterrupt maternal fetal transmission of hepatitis B virus and decrease the HBV infection rate of infants. The mechanism may be attributed to reducing the pregnant women's HBV viraemia and making the infants to gain passive immunoprophylaxis.[