孕晚期HBIG阻断HBV宫内感染失败的相关因素研究

Analysis of correlation factors of intrauterine interruption failure for HBV infected pregnant women using HBIG during the last trimester of pregnancy

目的:对晚孕期注射HBIG行宫内阻断的HBV-DNA阳性孕妇的新生儿的宫内阻断失败发生情况进行研究,分析母婴宫内阻断失败的相关因素。方法:将380例HBV-DNA阳性孕妇及其子女随访至1月龄,根据母血HBV-DNA定量(单位cp/ml)分为4组:A组<106级、B组106级、C组107级、D组≥108级,研究HBV-DNA含量与宫内阻断失败的关系。选择高病毒载量孕妇(HBV-DNA≥106cp/ml)及新生儿各176例分为宫内阻断成功组和失败组两组进行其他原因分析。结果:随母血HBV-DNA含量增高,宫内阻断失败率随之增加,4组失败率分别为0.97%、8.57%、15.57%、42.10%,差异有统计学意义(P<0.05);两组孕妇年龄、慢性乙型肝炎(乙肝)患者比例,HBV感染家族史及新生儿性别等差异无统计学意义(P>0.05);两组治疗前母血HBV-DNA对数、分娩时胎龄、治疗前母亲HBeAg定量比较,差异有统计学意义(P<0.05);经多因素回归分析治疗前母血HBV-DNA对数、分娩时胎龄差异有统计学意义(P<0.05)。结论:血清HBV宫内阻断失败的相关因素主要为母体HBV-DNA浓度,分娩时胎龄的延长增加了HBIG宫内阻断失败的风险。

Objective：To study the failure rate of interruption intrauterine HBV infection of the pregnant women whose HBV-DNA was positive and used HBIG to interrupt intrauterine infection during the last trimester,and analyze the correlation factors of intrauterine interruption failure.Methods：380 pregnant women with HBsAg and HBV-DNA positive who were given HBIG 200IU every 2 weeks during the last trimester were divided into 4 groups. The blood titer of HBV in group A,B,C,D was 106 grade,106 grade,107 grade and≥108grade respectively. The relationship between intrauterine interruption failure rate and serum virus content was analyzed.176 women with high blood titer of HBV were divided into 2 groups according to whether their infants were intrauterine infected to analyze other factors.Results：The failure rate of the four groups was 0.97%,8.57%,15.57% and 42.11% respectively..The value of association between the HBV infection rate and virus content in gravidic serum showed statistical significance.HBeAg content and delivery gestational age showed statistical significance between the successful group and the intrauterine infection group.But age,gender of infants didn＇t show statistical signification.After regression analysis HBV titer and delivery gestational age were found to have relationship with the failure of intrauterine interruption.Conclusion：The main factor of intrauterine interruption failure is high HBV DNA content of pregnant women.Prolongation of delivery gestational age increases the risk of intrauterine interruption failure.