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目的探讨阻断乙型肝炎病毒母婴传播的有效方法。方法将乙型肝炎病毒携带孕妇,根据她们的不同情况和就诊的不同时期分为6组,Ms组为乙肝表面抗原阳性乙肝e抗原阴性的孕妇,根据就诊的不同时期分为Ms1组、Ms2组、Ms3组。Mse组为乙肝表面抗原和乙肝e抗原双阳性孕妇。MF组为孕妇与配偶均为乙型肝炎病毒携带者。F组为孕妇为非乙型肝炎病毒携带者配偶为乙型肝炎病毒携带者的孕妇。各组采用不同的方法阻断乙型肝炎病毒的垂直传播。结果 Ms1组230例中有22例母亲孕期用过乙肝免疫球蛋白(占本组总数9.6%)。Ms2组:372例中有37例母亲孕期用过乙肝免疫球蛋白(占本组总数9.9%)。Ms3组287例中有4例母亲孕期检测乙型肝炎病毒脱氧核糖核酸阳性用过HBIG(占本组总数1.4%),与Ms1组和Ms2组母亲用乙肝免疫球蛋白率9.6%和9.9%比较经统计学处理差异都非常显著(χ2=17.850,P=0.000);(χ2=20.311,P=0.000)。Mse组32例母亲在孕期都用过乙肝免疫球蛋白(占本组总数100%)。MF组72例中有20例母亲在孕期用过乙肝免疫球蛋白(占本组总数27.7%)。F组:48例中3例母亲在孕期用过乙肝免疫球蛋白(占本组总数6.2%);32例母亲在孕期用过乙肝疫苗接种(占本组总数66.6%)。各组共1041例新生儿生后24h内静脉血乙肝抗原抗体定性检测:乙肝表面抗原和乙肝e抗原均为阴性。生后3个月至1岁随访检测婴儿静脉血1041例乙肝抗原定性乙肝表面抗原和乙肝e抗原仍均为阴性。结论孕妇或配偶为乙型肝炎病毒携带者,如乙肝e抗原阳性或乙型肝炎病毒脱氧核糖核酸阳性孕妇孕期需要注射乙肝免疫球蛋白阻断乙型肝炎病毒传播,否则不需要。父母为乙型肝炎病毒携带者,如新生儿生后检测乙型肝炎病毒抗原检测阳性需要注射乙肝免疫球蛋白,否则不需要。所有新生儿必须接种乙肝疫苗。
Objective To explore an effective way to block the transmission of hepatitis B virus from mother to child. Methods Hepatitis B virus was carried in pregnant women and divided into 6 groups according to their different situations and different periods of treatment. Ms group was negative for hepatitis B surface antigen (HBeAg) -positive hepatitis B e antigen, and divided into Ms1 group, Ms2 group , Ms3 group. Mse group hepatitis B surface antigen and hepatitis B e antigen double positive pregnant women. MF group for pregnant women and their spouses are hepatitis B virus carriers. Group F is a pregnant woman whose mother is a non-Hepatitis B virus carrier spouse is a Hepatitis B virus carrier. Each group used different methods to block the vertical transmission of hepatitis B virus. Results In the Ms1 group, 22 of the 230 infants had hepatitis B immunoglobulin during pregnancy (9.6% of the total). Ms2 group: In 372 cases, 37 mothers used hepatitis B immunoglobulin during pregnancy (accounting for 9.9% of the total). Four of the 287 women in the Ms3 group were HBsAg-positive (1.4% of the total) in their mothers during pregnancy, compared with 9.6% and 9.9% of the HBsAg-HBs in the women in the Ms1 and Ms2 groups The difference was statistically significant (χ2 = 17.850, P = 0.000); (χ2 = 20.311, P = 0.000). 32 mothers in the Mse group used hepatitis B immunoglobulin during pregnancy (100% of the total). In the MF group, 20 of the 72 mothers used hepatitis B immunoglobulin during pregnancy (27.7% of the total). In Group F, 3 of the 48 mothers used hepatitis B immunoglobulin during pregnancy (6.2% of the total), while 32 mothers used hepatitis B vaccine during pregnancy (66.6% of the total). A total of 1041 newborns in each group within 24 hours after intravenous hepatitis B antigen antibody qualitative detection: hepatitis B surface antigen and hepatitis B e antigen were negative. A total of 1041 infant venous blood samples from 3 months after birth to 1 year follow-up were still negative for the detection of hepatitis B surface antigen (HBsAg) and hepatitis B e antigen. Conclusion Pregnant or spouse are carriers of hepatitis B virus such as hepatitis B e antigen positive or hepatitis B virus DNA positive pregnant women need hepatitis B immunoglobulin injection during pregnancy to block the spread of hepatitis B virus, otherwise it is unnecessary. Parents of hepatitis B virus carriers, such as neonatal detection of hepatitis B virus antigen post-mortem test requires the injection of hepatitis B immunoglobulin, or do not need. All newborns must be vaccinated against hepatitis B