摘要
目的 评价产前和产后联合阻断措施对HBsAg、HBeAg阳性孕妇母婴传播的免疫效果。方法 将HBsAg、HBeAg阳性的孕妇在产前检查时随机分成两组 ,乙型肝炎免疫球蛋白 (HBIG)组 :孕妇产前 3个月 (妊娠 2 8周起 )每 4周肌内注射HBIG 4 0 0IU直至临产 ;对照组 :孕妇不注射HBIG。两组所生新生儿出生时及 15d时肌内注射HBIG ,满月、2月和 7月龄接种乙型肝炎疫苗 ,定期检测婴儿外周血的乙型肝炎病毒 (HBV)感染标志。 10 4例HBsAg、HBeAg阳性孕妇所生 10 5例新生儿完成随访满 1年。结果 5 1例新生儿系HBIG组母亲所生 ,宫内感染率为 5 .9% ,达 1岁时HBV慢性感染率为 5 .9% ,具有保护性抗体水平的有效保护率达 94 .1% ;5 4例对照组母亲所生新生儿的宫内感染率为 18.5 % ,随访至 1岁龄的HBV慢性感染率为 16 .7% ,抗体有效保护率是 83.3%。宫内感染率之比 χ2 =3.86 ,P <0 .0 5。结论 产前和产后联合阻断HBsAg、HBeAg阳性孕妇的母婴传播 ,其有效保护率达到 94 % ,能明显减少宫内感染的发生 ,获得目前最大限度的提高对HBsAg。
Objective The infants born to hepatitis B virus (HBV) carrier mothers are the high risk children who are susceptible to HBV infection. About ten years of studies show that hepatitis B virus vaccine plus hepatitis B immunoglobulin (HBIG) inoculation can interrupt mother to infant transmission, which has been generally accepted. About 70%～90% children can be protected by this way. Intrauterine HBV infection is responsible for most of the immunoprophylaxis failure, so we study on a combined antepartum with postpartum to interrupt transmission of HBV from HBsAg positive and HBeAg positive mothers to their infants. Methods HBV carrier mothers, whose HBsAg and HBeAg were both positive, and later their infants were randomly divided into two groups. The gravidas in group 1 received 400 IU HBIG every four week (from pregnancy for 28 week to delivery); the gravidas in group 2 didn't receive any HBIG (the control group). After delivery, all the infants in both groups were given 2 dose of 200 IU HBIG at birth and at 15 days, then accepted 3 dose of HBV vaccine at 1, 2 and 7 months. These infants were periodically followed up until 1 year of age and their sera were obtained to test HBV markers. 104 mothers and their 105 infants were followed for 12 months. Results There were 51 infants in group 1 and 54 infants in group 2. In group 1, the rate of intrauterine HBV infection was 5.9%, and at 12 month old, the rate of chronic HBV infection was 5.9% and the rate of infants with the protective level against HBV infection was 94.1%. In group 2, the rate of intrauterine HBV infection was 18.5%, and at 12 month old, the rate of chronic HBV infection was 16.7% and the rate of infants with the protective level against HBV infection was 83.3%. χ 2 test was used to compare the different rates of intrauterine HBV infection between the two groups (χ 2=3.86, P <0.05). Conclusions More than 94% high risk infants, who were born to HBsAg positive and HBeAg positive carrier mothers, were protected by the antepartum with postpartum of immunoprophylaxis, which can significantly interrupt the transmission of HBV from mothers with both positive HBsAg and HBeAg to their infants.
出处
《中华传染病杂志》
CAS
CSCD
北大核心
2004年第3期160-163,共4页
Chinese Journal of Infectious Diseases
基金
卫生部临床重点学科建设项目(970 3 0 2 2 3 )
