产前和产后联合阻断 HBsAg 阳性孕妇母婴传播的研究.doc

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1、产前和产后联合阻断HBsAg阳性孕妇母婴传播的研究【摘要】目的评价产前和产后联合阻断措施，对乙型肝炎表面抗原（HBsAg）阳性孕妇母婴传播的阻断效果。方法将乙型肝炎表面抗原（HBsAg）阳性的孕妇在产前检查时随机分为两组，人乙型肝炎免疫球蛋白（HBIG）组：HBsAg、HBeAg双阳性组孕妇产前4个月（妊娠24周起）每4周肌肉注射HBIG200IU直至临产；HBsAg单阳组孕妇产前3个月（妊娠28周起）每4周肌肉注射HBIG200IU直至临产；对照组孕妇不注射HBIG。两组所生新生儿于出生后2h内及2个月取股静脉血，检测乙型

2、肝炎病毒感染标志HBVM。双阳性组母亲分娩新生儿每10天肌肉注射HBIG200IU，单阳组母亲分娩新生儿每15天肌肉注射HBIG200IU。结果HBIG组母亲所生新生儿宫内感染率为2.6%，2个月时具有保护性抗体有效保护率为95.6%；对照组母亲所生新生儿宫内感染率为39.3%，2个月时具有保护性抗体的有效保护率为76.4%，宫内感染率比较χ2=3.86，P<0.05。结论产前和产后联合阻断乙型肝炎病毒的母婴传播有效保护率达到95.6%，能明显减少宫内感染的发生，获得目前最大限度的提高对乙型肝炎病毒母婴传播的阻断作用。

3、【关键词】乙型肝炎病毒母婴阻断人乙型肝炎免疫球蛋白垂直传播.【Abstract】ObjectiveToevaluatetheeffectofcombiningantepartumwithpostpartumtobreakuptransmissionofHBV.MethodsHBVcarriermother，whoseHBsAgpositive，andlatertheirinfantswererandomlydividedintotwogroups.Thegravidsingroup-1，whoseHBsAgandHBeAgw

4、erebothpositive，received200IUHBIGevery-four-week(frompregnancyfor24weektodelivery).Thegravidsingroup-1，whoseonlyHBsAgwaspositive，received200IUHBIGevery-four-week(frompregnancyfor28；weektodelivery).Thegravidsingroup-2didnotreceivedHBIG(thecontrolgroup).Afterdelivery

5、，alltheinfantsinbothgroupsobtainedserafromfemoralveintotestHBVmarkers，intwohoursandattwomonths.TheinfantsofmotherwhoseHBsAgandHBeAgwerepositive，received200IUHBIGevery-ten-day.TheinfantsofmotherwhoseonlyHBsAgwaspositive，received200IUHBIGevery-fifteen-day.ResultsIngr

6、oup-1，therateofintrauterineHBVinfectionwas2.6%，andattwo-month-old，therateofinfantswiththeprotectivelevelagainstHBVinfectionwas95.6%.Ingroup-2，therateofintrauterineHBVinfectionwas30.3%，andattwo-month-old，therateofinfantswiththeprotectivelevelagainstHBVinfectionwas76

7、.4%.χ2-testwasusedtocomparethedifferentratesofintrauterineHBVinfectionbetweenthetwogroups.(χ2=3.86P<0.05).ConclusionMorethan95.6%high-riskinfants，whowereborntoHBsAg-positivecarriermother，wereprotectedbytheantepartumwithpostpartumofimmunoprophylaxis，whichcansigni

8、ficantlyinterruptthe4transmissionofHBVfrommotherswithpositiveHBsAgtotheirinfants.【Keywords】hepatitisBvirusinterruptionofmaternal-infantiletransmi