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目的评估拉米夫定联合主被动免疫对阻断HBV母婴传播的疗效。方法对HBV感染的孕妇随机分为4组,分别给予拉米夫定、HBIG、拉米夫定和HBIG治疗、同时设不治疗为对照组,分别用ELISA、定量PCR检测孕28周及分娩前孕妇HBV血清标志物及HBV DNA含量,以及新生儿、12个月婴儿血清HBV标志物、HBV DNA含量。结果拉米夫定、HBIG、拉米夫定和HBIG治疗与对照组相比,可显著降低孕妇血HBV DNA水平(P<0.01),降低新生儿宫内感染率(P<0.001),增强12个月婴儿抗-HBs阳转率及抗体滴度。结论拉米夫定及HBIG均可有效阻断HBV母婴垂直传播,减少婴幼儿HBV感染。
Objective To evaluate the efficacy of lamivudine plus primary and passive immunization in blocking the transmission of HBV from mother to infant. Methods Pregnant women with HBV infection were randomly divided into 4 groups and treated with lamivudine, HBIG, lamivudine and HBIG respectively. At the same time, no treatment was taken as control group. Pregnant women, serum HBV DNA and HBV DNA levels, as well as newborns, 12-month-old baby serum HBV markers, HBV DNA content. Results Compared with the control group, lamivudine, HBIG, lamivudine and HBIG significantly decreased the level of serum HBV DNA in pregnant women (P <0.01), decreased the intrauterine infection rate (P <0.001) and increased 12 Anti-HBs positive rate and antibody titers in infants in one month. Conclusions Both lamivudine and HBIG can effectively block the vertical transmission of HBV maternal and infant and reduce HBV infection in infants and young children.