论文部分内容阅读
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、HBcAg阳性母亲HBV母婴传播的阻断作用
Objective To evaluate the immune effect of prenatal and postpartum joint blockade on mother-to-infant transmission of HBsAg and HBeAg-positive pregnant women. Methods HBsAg and HBeAg positive pregnant women were randomly divided into two groups at the time of prenatal examination. HBIG group: pregnant women were intramuscularly injected with HBIG 4 every 3 weeks (from the 28th week of pregnancy) 0IU until abortion; control group: pregnant women do not inject HBIG. HBsAg was injected intramuscularly at birth and 15 days after birth in newborns of both groups. Hepatitis B vaccine was administered at full moon, February and July, and hepatitis B virus (HBV) markers in infants’ peripheral blood were detected regularly. A total of 10 5 newborns were enrolled in 10 4 HBsAg and HBeAg positive pregnant women and were followed up for 1 year. Results 5 1 neonates were born to HBIG mothers with an intrauterine infection rate of 5.9%. The HBV infection rate was 5.9% at 1 year of age and the effective protection rate with protective antibody level was 94.1 %. The intrauterine infection rate of neonates born to mothers in 54 control subjects was 18.5%. The HBV infection rate was 16.7% at follow-up to 1 year old and the effective protection rate was 83.3%. Intrauterine infection rate ratio χ2 = 3.86, P <0. Conclusion Prenatal and postpartum joint block HBsAg, HBeAg-positive pregnant women, mother-to-child transmission, the effective protection rate of 94%, can significantly reduce the incidence of intrauterine infection, access to the maximum to improve HBsAg, HBcAg-positive mothers HBV The blocking effect of transmission