乙型肝炎基因工程疫苗对阻断乙肝母婴传播的效果观察

Study on the efficacy of the genetic engineering vaccines against Hepatitis B for interruption of perinatal transmission

ＨＢｓＡｇ兼ＨＢｅＡｇ、抗－ＨＢｃ均阳性母亲所生婴儿的感染率高达８５％，作者将在该院出生的本组婴儿１４２例分为３组，运用不同来源的基因工程疫苗接种。Ｉ组：用痘苗重组ＤＮＡ乙肝疫苗５７例，在婴儿娩出后１个月、６月龄进行注射，每次２０ｕｇ。ＩＩ组：应用乙型肝炎疫苗（基因工程细胞生产）４１例，其用法同Ｉ组。ＩＩＩ组：疫苗来源同Ｉ组，出生时同时给以乙肝免疫球蛋白（ＨＢＩＧ）１支，含量为２００Ｕ／ｍｌ，每次ｌｍｌ，臂部肌内注射，１、６月龄重复注射上述疫苗１０ｕｇ。其保护率分别为８８．２％、８５．９％、１００％，抗－ＨＢｓ阳转率分别为８２％、８６％、９８％、经过统计学处理，ＩＩＩ组与Ｉ组相比，Ｐ＜０．０５，差异有显著性；ＩＩ组与ＩＩＩ组相比，Ｐ＜０．０５，差异亦有显著性。ＩＩＩ组免疫方案优于Ｉ、ＩＩ组，且在ＩＩＩ组４４例中，无１例感染，其免疫效果亦优于血源性乙肝疫苗。基因疫苗的问世，为乙肝母婴传播阻断开辟了新的途径。

The infectivity rate of newborn babies who had been borne from HBsAg(+),HBeAg(+) and anti-HBc (+) mothers was very high (85%). 142 babies born in the hospital were divided into three groups,in this study. In the group 1, 57 babies were inoculated with 20μg recombinant DNA vaccinia vaccines against hepatitis B. The injections were given at newborn, l month , and 6 months, respectively. In group 2, 41 babies were inoculated with 20μg genetic engineering vaccines against hepatitis B at same time were intervals as group l. In group 3, 44 newborn babies were inoculated with 10μg as same vaccines as group 2 HBIG plus 1ml(200 U/ml),at same time intervals as group l.The immune pretection rates of newborn babies in three groups were 88. 2%、85. 9% and 100%,respectively. The anti-HBs pasitive conversion rates were 82%. 86% and 98%,respectively. The group 3 was compared with group 1 and 2. Statistical analysis showed the significant differences (P<0.05). The result showed the immune program of group 3 was superior to that of group 1 and 2 ,and none of the 44 babies in group 3 were infected. The efficacy of immunization by genetic engineering vaccines were superior to that of blood-derived vaccine. The genetic engineering vaccines against hepatitis B would be more useful for interruption of perinatal transmission of HBV.