HBV宫内感染与孕期使用乙肝免疫球蛋白关系.docVIP

HBV宫内感染与孕期使用乙肝免疫球蛋白关系 【摘要】目的探讨孕期使用乙肝免疫球蛋白对乙型肝炎病毒(HBV)宫内感染的保护作用及其对孕妇病毒滴度的影响。方法以HBsAg阳性孕妇及其新生儿为研究对象，以孕期使用过乙肝免疫球蛋白的孕妇为干预组，其余为对照组，比较2组乙型肝炎病毒(HBV)宫内传播发生率、病毒载量的差异，探讨乙肝免疫球蛋白的保护作用及其机制。结果干预组孕妇210例，有10例新生儿发生宫内感染；对照组402例，有15例发生宫内感染，差异无统计学意义。相关分析显示，乙肝免疫球蛋白使用剂量与HBV DNA拷贝数、HBsAg滴度无关。结论孕期使用乙肝免疫球蛋白不能降低孕妇病毒载量，对HBV宫内传播也无保护作用。 【关键词】 肝免疫球蛋白 宫内传播 乙型肝炎 Association of administration of hepatitis B immunoglobulin during pregnancy with intrauterine infection of HBV SHAO Zhong-jun,LI Jing-hua,XU De-zhong,et al. Department of Epidemiology,School of Public Health,Fudan University (Shanghai 200032,China) Abstract： Objective To explore the protective effect of HBIG administrated during pregnancy against HBV intrauterine infection and its candidate mechanism.Methods 210 HBsAg positive pregnant women who were consecutively collected and were administered with HBIG were selected as intervention group.402 consecutively collected HBsAg positive pregnant women who were not administered with HBIG were selected as controls.Incidence of HBV intrauterine transmission was compared between 2 groups.Titer of HBsAg and copies of HBV DNA in maternal sera of intervention group were detected for explorating its considerate mechanism.Results Ten neonates in intervention group and 15 in control group were detected as occurrence of HBV intrauterine infection and the difference was non significant by Chi-square test.There were no significant relation between titer of HBsAg or copies of HBV DNA and frequency of HBIG administration with R-value 0.039 or 0.012 respectively (P0.05).Conclusion HBIG administration during pregnancy didnt decrease the titer of HBsAg and copies ofHBV DNA,and the protective effect on HBV intrauterine infection was not found. Key words： hepatitis B immunoglobulin;intrauterine transmission;hepatitis B 孕妇孕期使用乙肝免疫球蛋白(Hepatitis B immunoglobulin，HBIG)是阻断乙型肝炎病毒(Hepatitis Bvirus，HBV)宫内传播的主要方法之一。有研究认为,HBIG能降低孕妇体内HBV病毒载量，从而达到预防HBV宫内传播的效果〔1,2〕。然而其保护作用及预防机制都存有争议〔3〕。本研究对HBIG的保护作用及其对孕妇体内HBV病毒载量、HBsAg滴