孕妇携带乙型肝炎病毒载量影响被动免疫预防宫内感染效果的研究

Capacity of B Type Hepatitis Virus Influencing the Result of Passive Immunity in Pregnant Women for Preventing Intrauterine Infection

目的 探讨孕妇携带乙型肝炎病毒DNA(HBVDNA)的载量 ,对注射乙型肝炎免疫球蛋白 (HBIG)预防宫内传播效果的影响。方法 将 2 16例不同HBVDNA载量的孕妇分成 2组 ,预防组 118例 ,自孕 2 8周起每 4周注射HBIG 1次至分娩为止 ;对照组 98例 ,不用HBIG ;母血、脐血用荧光定量PCR法检测HBVDNA。结果 预防组发生宫内感染率显著低于对照组 (2 1 2 %与 35 7% )P <0 0 5 ;HBVDNA拷贝 >10 8两组间的宫内感染率差异无显著性P >0 0 5 ;HBVDNA拷贝 10 6～ 10 8两组间的宫内感染率差异存在显著性P <0 0 1;孕妇血清中不同载量HBVDNAlog拷贝与新生儿宫内感染率进行直线回归分析 ,相关系数为 0 96 73,成正相关。结论 孕妇携带乙型肝炎病毒载量的增加 ,影响注射乙型肝炎免疫球蛋白 (HBIG)预防宫内感染的效果 ,目前 ,合理使用HBIG仍为预防HBV宫内感染的根本措施之一。

OBJECTIVE To inquire the influence of the capacity of B type hepatitis virus DNA (HBV DNA) carried by pregnant women on the result of passive immunity by injecting hepatitis B immunoglobulin (HBIG) for preventing intrauterine infection. METHODS A total of 216 cases with different capacity of HBV DNA were divided into two groups. The prevention group consisted of 118 cases who were injected HBIG every 4 weeks since the 28th week of pregnancy till childbirth. The control group with 98 cases was without use of HBIG. The HBV DNA in mother blood and the blood of umbilicus was detected by the fluorescence quantitative PCR method. RESULTS The intrauterine infection rate in prevention group showed significantly lower than the control one (21.2% vs 35.7%, P<0.05), but when HBV DNA copies were >10 8, the difference between two groups in intrauterine infection rate was not significant (P>0.05). When HBV DNA copies were 10 6-10 8 their difference became significant (P<0.01). The linear regression analysis between different capacity of HBV DNA log copies in serum of pregnant women and their newborn intrauterine infection rate was positively correlated, the correlation coefficient was 0.9623. CONCLUSIONS The increment of capacity of HBV carried by pregnant women could influence the result of passive immunity by injecting HBIG for preventing intrauterine infection. Till now, reasonable application of HBIG is still a radical measure for preventing HBV intrauterine infection.