云南省乙型肝炎母婴阻断实施效果评价

目的　了解云南省现阶段住院分娩新生儿乙型肝炎（乙肝）母婴阻断的效果。方法　在全省范围内筛查2011年1—6月住院分娩HBsAg阳性孕产妇，并对其婴儿实施母婴阻断措施，于免疫后7～12月龄时采集婴儿静脉血2ml检测HBV血清学5项指标并统计分析。结果　调查对象共计2765人，平均母婴阻断成功率为95．88％；乙肝疫苗（HepB）24h内首针及时接种率为97．03％，全程接种率为92．30％；乙肝免疫球蛋白（HBIG）接种率为68．97％，HBIG及时接种率为94．49％，联合免疫率为60．94％。主、被动联合免疫（及时接种HepB和HBIG）阻断成功率（97．16％）显著高于单纯用HepB阻断的成功率（93．01％）；无论是否联合免疫，HBsAg及HBeAg双阳性母亲所生婴儿的阻断成功率显著低于HBsAg单阳性母亲。结论　HepB和HBIG联合免疫阻断母婴传播效果优于非联合免疫，对HBsAg／HBeAg阳性母亲所生婴儿实施规范联合免疫更为关键。

Evaluation on the efficacy of prevention programs and relevant factors targeting mother-to-infant transmission on hepatitis B virus in Yunnan province

Objective To explore the efficacy of prevention programs and relevant factors targeting mother-to-infant transmission of HBV in Yunnan province. Methods In Yunnan province, we selected HBsAg positive pregnant women that delivered in hospital from January 1st through June 30th, 2011. Newborns of these pregnant women were under PMTCT(prevention of mother to child treatment) program and followed. Every infant was drawn 2 ml venous blood and questionnaire survey was carried out when the baby was 7-12 month-old and completed the vaccination processes. Serum samples of them were then collected and detected on the 5 serological indicators of HBV Results were analyzed statistically. Results 95.88%.Rates of cov There were 2765 infants in the study program. The success rate of PMTCT was erage on both respectively. The overall vaccinated (HBIG) were timely-birth dose and 3 doses of HepB were 97.03% and 92.30% rate and timely-birth vaccinated rate on hepatitis B immunoglobulin 68.97% and 94.49% respectively. The success rate administration of passive-active immune-prophylaxis ( HepB and HBIG ) of PMTCT was 97.16% after, compared to the rate as 93.01 % when vaccinated with HepB only. Significant differences were seen in the successful rates of PMTCT between combined and non-combined immunization. Either the combined or non-combined immunization, there were significant differences seen in the success rates of PMTCT regardless the positivity status of HBsAg or HBeAg, among the infected mothers. Conclusion The efficacy of passive-active immune-prophylaxis program seemed to be better than the one without combined immunization. It was vitally important for the infants whose mothers'' HBsAg and HBeAg status were positive, to receive regular and timely combined immunization. In order to promote the PMTCT in Yunnan province, vaccinated rate on HBIG should be further improved.