不同喂养方式对乙型肝炎病毒母婴传播影响.docVIP

不同喂养方式对乙型肝炎病毒母婴传播的影响 　　【摘要】 目的：探索不同喂养方式对乙型肝炎病毒母婴传播的影响。方法：选取2013年 　　1月-2015年5月在本院足月分娩的携带乙肝病毒（Hepatitis B Virus，HBV）孕妇796例，根据喂养方式分为母乳喂养组（包括混合喂养）370例及人工喂养组426例，对其所生新生儿出生后即刻检测血清乙肝病毒标志物（Hepatitis B Virus Markers，HBVM），并常规肌肉注射重组酵母乙肝疫苗（Hepatitis B Vaccine，HBVac）10 μg，同时在另一部位肌肉注射乙肝免疫球蛋白（Hepatitis B Immunoglobulin，HBIG）200 U，3个月再次检测HBVM。结果：母乳喂养组及人工喂养组的新生儿出生时HBV感染率分别为11.3%和11.5%，3个月龄时感染率分别为3.5%和3.3%，两组比较差异均无统计学意义（P0.05）；两组婴儿出生时与本组3个月龄时HBL感染率比较，差异均有统计学意义（ 字2=16.519、20.997，P0.001）。结论：携带HBV的孕妇所生新生儿，出生后即肌注HBVac 10 μg联合HBIG 200 U可以明显降低HBV感染率。经联合免疫预防后，喂养方式与HBV母婴传播无明显相关性。 　　【关键词】 乙型肝炎病毒； 乙肝免疫球蛋白； 母婴传播； 母乳喂养 　　【Abstract】 Objective：To analyze the effects of different feeding methods on the mother-to-infant transmission of HBV.Method：796 pregnant women at term birth who were carrying HBV were selected from January 2013 to May 2015，according the feeding situation，they were divided into breast feeding group （including mixed feeding） of 370 cases and artificial feeding group of 426 cases，then the neonates born for them were tested the hepatitis B virus markers in serum.All the neonates were treated with conventional intramuscular injection of HBVac 10μg and HBIG 200 U in other part.Three months later the hepatitis B virus markers in serum were detected.Result：The infection rates of HBV in the neonates born of breast feeding group and artificial feeding group were respectively 11.3% and 11.5%，the infection rates of HBV in 3 months old infants of two groups were respectively 3.5% and 3.3%，there were no significant differences（P0.05）. The difference of HBV infection rate between two groups at birth and 3 months old were statistically significant（ 字2=16.519，20.997；P0.001）.Conclusion：For the neonates who are born by the mothers carrying HBV，injecting HBIG 200 U and HBVac 10 μg after birth can effective reduce the HBV infection rates.After the joint immune prevention，there is no obvious correlation of feeding way and mother-to-infant transmission of HBV 　　【Key words】 Hepatitis B virus； He