孕晚期注射乙肝免疫球蛋白预防HBV宫内感染的探讨

Study on anti-HBV immunoglobulin in preventing intrauterine infection of HBV

目的探讨孕晚期应用乙肝免疫球蛋白(HBIG)阻断乙型肝炎病毒(HBV)宫内感染的有效性。方法随机选取2002年1月至2004年12月在本院系统产检分娩的乙肝表面抗原(HBsAg)阳性的孕妇及其分娩的新生儿共100例为研究对象。孕期注射HBIG者为观察组共50例,孕期无注射HBIG者为对照组共50例。观察组孕妇于孕28周、32周、36周分别注射HBIG200IU。两组孕妇于孕28周前、分娩前抽取静脉血并于分娩断脐后立即采集脐带血进行乙肝五项检测。结果母血的HBeAg阳性率,观察组为48%(24/50)、对照组为38%(19/50),脐血HBsAg阳性率及HBsAb阳性率,观察组为4%(2/50)、6%(3/50);对照组为6%(3/50)、8%(4/50)。结论HBsAg阳性人群中并HBeAg阳性的乙肝双阳者多,易发生宫内传播。HBIG注射阻断HBV宫内感染率观察组虽较对照组发生率低,但两组比较无统计学差异(P>0.05)。

Objective To explore the potency of anti - HBV immunoglobulin（HBIG） in bilking HBV intrauterine infection during pregnancy of HBsAg female carrier. Methods From January 2032 to December 2004,random selecled 100 cases of HBsAg positive pregnant womem in the hospital were divided into two groups：50% of them in experimental group were treated with HBIG 200ǚ on week 28,week 32 and week 36 respec - ively.The other 50% cases in control group received no treatment. ELISA method was used to detect the serum of pregnanl women and cord HBsAB of the newborns. Results The HBeAg positive rate of gravidas in the experimental group was 48% and 38% in the control group. The HBsAg and HBsAb positive rate of cord blood was; 4% and 6 % in the experimenlal group; Meanwhile, i it was 6 % and 8 % in the control group. Conclusion Newborns of the ttBsAg positive combined with HBeAg positive gravidas; were susceptible to HBV intrauterine infection. The HBV intrauterine infection could possibly decreased by using HBIG daring pregnancy, but there is no statitisties between the two groups in this studuy（ P 〉 0.05）.