根据乙肝表面抗原滴度注射不同剂量乙肝免疫球蛋白降低胎儿宫内感.docVIP

根据乙肝表面抗原滴度注射不同剂量乙肝免疫球蛋白降低胎儿宫内感 　 作者：汪洪，郭晓玲，梁少联，陈咏涛，张国华，刘金凤 【摘要】 目的 根据乙肝表面抗原（HBsAg）滴度不同，注射不同剂量的乙肝免疫球蛋白（HBIG）,以降低高滴度HBsAg孕妇的宫内感染率的研究。方法 选取2004年12月—2007年12月在本院系统产检分娩的乙肝表面抗原（HBsAg）阳性的孕妇及其分娩的新生儿共385例为研究对象。孕妇于孕28周前抽取静脉血查HBsAg滴度、HBeAg及HBV-DNA，观察组170例孕妇于孕28周、32周、36周分别注射HBIG 400IU，对照组215例同期注射HBIG 200IU。两组患者产后即时抽取胎儿脐血，查乙肝两对半及HBV-DNA，若HBsAg（+）和（或）HBeAg（+）或HBV-DNA（+），确定为胎儿宫内感染。 结果 单纯低滴度HBsAg患者胎儿宫内感染率为11%，10%，差异无 显著性；单纯高滴度HBsAg患者胎儿宫内感染率为9%，18%，差异有显著性；低滴度HBsAg（+）合并HBeAg（+）或（和）HBV-DNA（+）患者胎儿宫内感染率为13%，13%，差异无显著性；高滴度HBsAg（+）合并HBeAg（+）或（和）HBV-DNA（+）患者胎儿宫内感染率为15%，21%，差异有显著性。 结论 对HBsAg滴度较高的孕妇，尤其是合并HBeAg阳性或（和）抗HBc阳性的孕妇，注射较大安全剂量的HBIG以阻断胎儿宫内感染率是可行的。 【关键词】 乙型肝炎病毒；乙肝免疫球蛋白；宫内感染 【Abstract】 Objective According to the titer of HBsAg, injection of different doses of HBIG, in order to reduce the high titer HBsAg intrauterine infection of pregnant women?s studies.Methods Select from December 2004 to December 2007, seized the delivery of HBsAg-positive pregnant women and their newborn?s birth to a total of 385 cases for the study. Before 28 weeks pregnant ,Pregnant women search titer HBsAg, HBeAg and HBV-DNA, Observer Group 170 cases of pregnant women at 28 weeks pregnant, 32 weeks and 36 weeks were injected HBIG 400IU, in the control group 215 cases of injection HBIG 200IU. Two groups of patients with post-natal fetal cord blood taken from real-time, Richard HBsAg 、HBeAg and HBV-DNA, if HBsAg (+) and / or HBeAg (+) or HBV-DNA (+), identified as intrauterine infection; Results HBsAg simple low titer in patients with intrauterine infection rate was 11%, 10%, no significant difference; high-alone patients titers HBsAg intrauterine infection rate was 9 percent, 18 percent, a significant difference; low titer HBsAg (+) Merger HBeAg (+) and / or HBV-DNA (+) patients, intrauterine infection rate was 13%, 13%, no significant difference; high-titer HBsAg (+) merger HBeAg (+) or / And HBV-DNA (+) patients, intrauterine infection rate was 15 percent, 21 percent, a significant difference.Conclusions HBsAg h