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1、联合免疫对阻断乙肝病毒母婴垂直传播的疗效研究?1812?'⑥ChineseGeneralPractice露3Uno一2011v刚-6A联合免疫对阻断乙肝病毒母婴垂直传播的疗效研究刘佩芝,詹爱琴,王英红,张红,李莎,王萍【摘要】目的探讨乙型肝炎病毒(HBV)表面抗原(HBsAg)阳性,同时HBV—DNA阳性(双阳性)母亲经乙肝高效价免疫球蛋白(HBIG)和乙肝疫苗联合免疫后所产婴幼儿的免疫效果及注射HBIG方法不同对双阳性孕妇的HBV宫内感染阻断作用.方法将228例双阳性孕妇分为4组:A组于妊娠26周,3O周和34周时分别肌肉注射基因工程乙
2、肝疫苗2Og,共3次;B组于妊娠26周,30周和34周时分别肌肉注射HBIG200U,共3次;C组于妊娠26周,30周和34周时分别肌肉注射基因工程乙肝疫苗20g,共3次,同时于妊娠28周,32周和36周时分别肌肉注射HBIG200U,共3次:D组(对照组)孕期未进行任何阻断乙肝母婴传播的干预.4组新生儿均于出生后6h内和2周注射HBIG200U,满月起按1,2,7月龄分别接种乙肝疫苗,并定期随访.结果A,B,c,D4纽宫内感染率分另1为7.8%,14.0%,7.7%,29.0%,A,B,C组新生儿的HBsAg阳性率在出生时,出生后6个月
3、及12个月时均低于D组,差异均有统计学意义(P<0.05);而A,B,c组间差异无统计学意义(P>0.05).抗一HBs阳性率在出生后12个月时分别为86.3%,82.O%,89.2%和62.9%,而A,B,C组的抗一HBs阳性率在出生后6个月及12个月均高于D组(P<0.05).4组新生儿出生时抗一HBs阳性率比较,差异无统计学意义(P>0.05).结论对HBsAg伴HBV—DNA双阳性孕妇,选择注射乙肝疫苗,HBIG或乙肝疫苗联合HBIG注射能有效减少HBV宫内感染的发生率.【关键词】肝炎病毒,乙型;免疫球蛋白
4、类;疫苗【中图分类号】R512.62【文献标识码】A【文章编号】1007—9572(2011)06—1812—03EfficacyofHepatitisBImmunoglobulin(HBIG)CombinedwithHepatitisBVaccineinHbsAg+/HBV—DNA+Preg-nantWomenLIUPei—zhi,ZHANAi～qin,WANGYing—hong,eta1.TheFirstAffiliatedHospital,MedicalCollegeofShi—heziUniversity,Shihezi83200
5、0,China【Abstract1ObjectiveToexploretheefficacyofhepatitisBimmunoglnbulin(HBIG)combinedwithhepatitisBvac—cineinHBsAg+/HBV—DNA+pregnantwomen.MethodsAtotalof228HBsAg+/HBV—DNA+pregnantwomenweredi—videdintofourgroups:groupsAreceived20IxgofhepatitisBvaccineonthe26th,30th,and34t
6、hgestationalweek;groupBreceived200IUofHBIGonthe26th,30th,and34thgestationalweek;groupCreceived20gofhepatitisBvaccineonthe26th,30th,and34thgestationalweekand200IUofHBIGontheir28th,32nd,and36thgestationalweek;andGroupD,asacon~olgroup.receivedneitherHBIGnorhepatitisBvaccinei
7、njection.A1lthenewbornsfromthesemothersreceived2ooIUofHBIGbothwithin6hoursand2weeksafterbirthandwerevaccinatedagainstHepatitisB1month.2months,and7monthsafterbirthviaroutinefollow—up.ResultsTheintrauterineinfectionratesofHBVwere7.8%,14.0%,7.7%and29.0%inthesefourgroups,resp
8、ectively.HBsAgpositiveratesamongnewbornsweresignificantlyloweringroupsA,B,andCthaningroupD(P<
