乙肝免疫球蛋白及乙肝疫苗联合阻断宫内感染疗效观察.docVIP

乙肝免疫球蛋白及乙肝疫苗联合阻断宫内感染疗效观察 　 作者：段文斌　王伯良　周小平　仲月霞 【关键词】 阻断 　　AntiHBV immunoglobulin combined with hepatitis B vaccine in preventing intrauterine infection of HBV 　　【Abstract】 AIM: To evaluate the potency of different methods in blocking HBV transmission from mother to the infants. METHODS: One hundred and twenty HBsAg/HBeAg positive pregnant women were assigned to three groups, of whom 42 pregnant women in group A were treated with HBV immune globulin combined with hepatitis B vaccine, 40 pregnant women in group B were treated with hepatitis B vaccine only, and 38 pregnant women in group C received no treatment. Pregnant women in group A and in group B were subjected to treatment from the 20 th week of gestation. ELISA method was used to detect the serum HBV biomarkers of pregnant women and serum HBsAg of the infants. RESULTS: The HBV infection rates of infants were 7% (3/42), 30% (12/40) and 37% (14/38) in group A, group B and group C respectively. The HBV infection rate of infants in group A was significantly lower than that in group B and in group C (Plt;001). CONCLUSION: Pregnant women carrying with hepatitis B virus treated with hepatitis B immune globulin combined with hepatitis B vaccine can significantly decrease their infants HBV infection rate, indicating that prophylaxis therapy can effectively block the HBV intrauterine transmission. 　　【Keywords】 preventive intervention；hepatitis B virus；intrauterine infection；HBV immunoglobulin；hepatitis B vaccine. 　　【摘要】目的: 探讨不同方法阻断母婴垂直传播的效果.方法: 将120例HBsAg和（或）HBeAg阳性的孕妇分成3组，A组42例给予乙肝免疫球蛋白和乙肝疫苗治疗，B组40例给予乙肝疫苗治疗，C组38例，未给任何治疗.A组和B组均在孕20 wk时开始注射，用ELISA检测孕妇HBV血清标志物和新生儿的血清HBsAg.结果: 新生儿A组感染率为7%（3/42）.B组感染率为30%（12/40）.C组感染率为37%（14/38）.A组HBV感染率明显低于B组与C组（Plt;001）.结论： 携带乙肝病毒孕妇于孕晚期给乙肝免疫球蛋白和乙肝疫苗联合治疗可有效地降低婴儿HBV感染率，表明干预性治疗可有效阻断HBV宫内传播. 　　【关键词】 阻断；乙型肝炎病毒；宫内感染；乙肝免疫球胆白；乙肝疫苗 　　0引言 　　孕妇携带的乙肝病毒可垂直传播给新生儿，虽然分娩时采取了许多措施，但完全阻断母婴传播还存在一定的困难.宫内感染是母婴传播的主要途径，是导致乙肝疫苗接种失败的主要原因［1］，因此，阻止母婴传播是控制乙肝流行的主要环节.我们采用乙肝免疫球蛋白和乙肝疫苗联合治疗来控制乙肝宫内传播，获得了明显的效果. 　　1对象和方法 　　1