不同乙肝免疫球蛋白干预方案对乙肝大三阳孕产妇发生乙肝病毒宫内传播的阻断作用分析

目的:分析不同乙肝免疫球蛋白(HBIG)用药方案对乙肝大三阳孕产妇发生乙肝病毒宫内传播的阻断作用。方法:选取2012年3月至2013年3月我院收治的150例乙肝大三阳孕产妇作为研究对象,根据其接受治疗的情况将其分为A组孕产妇、B组孕产妇和对照组孕产妇,每组各50例患者。为A组孕产妇采用肌肉注射HBIG 200U的干预方案,为B组孕产妇采用肌肉注射HBIG 400U的干预方案。对照组孕产妇因各种原因未使用HBIG进行治疗。在3组孕产妇分娩7个月后观察其血清HBsAg和HBV-DNA的指数,并对3组孕产妇发生宫内乙肝病毒感染的几率进行分析对比。结果:在A组孕产妇中有8例孕产妇的新生儿发生乙肝病毒宫内感染,其血清HBsAg和/或HBV-DNA持续呈阳性,发生乙肝病毒宫内感染的几率为16.0%;有6例孕产妇乳汁中HBV-DNA的检测结果呈阳性,阳性率为12.0.%。在B组孕产妇中有6例孕产妇的新生儿发生乙肝病毒宫内感染,感染率为12.0%;有6例孕产妇乳汁中HBV-DNA的检测结果呈阳性,阳性率为12.0%。在对照组孕产妇中有19例孕产妇的新生儿发生乙肝病毒宫内感染,感染率为38.0%;有16例孕产妇乳汁中HBV-DNA的检测结果呈阳性,阳性率为32.0%。A组孕产妇与B组孕产妇的新生儿发生乙肝病毒宫内感染的几率及其乳汁中HBV-DNA的阳性率相比较,差异不显著,无统计学意义(P>0.05)。A组孕产妇、B组孕产妇与对照组孕产妇的新生儿发生乙肝病毒宫内感染的几率及其乳汁中HBV-DNA的阳性率相比较,差异显著,有统计学意义(P<0.05)。本研究所有的孕产妇在肌注乙肝免疫球蛋白后均未发生不良反应及妊娠并发症。结论:为乙肝大三阳孕产妇肌注乙肝免疫球蛋白可有效阻断乙肝病毒的宫内传播,为其采取不同的乙肝免疫球蛋白干预方案取得的阻断乙肝病毒宫内传播的效果也略有不同。

objective: to analyze different scheme of hepatitis b immune globulin blocking effect of intrauterine transmission for the pregnant woman. Methods: selected from March 2012 March 2013 150 three big positive of HBV pregnant women as the research object, were randomly divided into group A and B group and the control group, 50 cases of each group of patients.Group A with intramuscular HBIG 200 U intervention, group B with intramuscular HBIG 400 U intervention,control group without intervention.Baby in July,the serum HBsAg and HBV DNA was observed,and the comparative analysis of intrauterine infection rates of three groups of women.Results:there are 8 cases in group A maternal intrauterine infection, the infection rate was 16.0%;Have 6 cases in group B maternal intrauterine infection,the infection rate was 12.0%;Control group of 19 cases of intrauterine infection,infection rate was 38.0%.Compared three groups of data found that there was no statistically significant difference compared with group A and group B (P>0.05),group A and group B compared with control group differences statistically significant (P<0.05).Conclusion:hepatitis b immune globulin intrauterine transmission for the pregnant woman has a good blocking effect,and different types of hepatitis b immune globulin intrauterine transmission for the pregnant woman blocking effect is also different.