孕期不同阶段应用HBIG阻断乙肝母婴传播效果初探

A study on the effect of HBIG blocking the hepatitis B to the maternal-infantile vertical transmission action

目的探讨孕期不同阶段应用HBIG阻断乙肝病毒宫内感染的效果。方法设计自孕20周起,给予乙肝孕妇每四周免疫HBIG一次,共5次。对比常用的孕晚期3次免疫方法及孕期无干预措施的乙肝孕妇,在脐血、新生儿外周血及羊膜、胎盘感染方面进行比较。结果20周免疫组新生儿宫内感染率与28周免疫组相比无明显减少,同时新生儿抗体产生率也无明显增加。但是在胎盘感染的微观方面,20周免疫组明显低于28周免疫组。两个干预组较未干预组相比宫内感染率都有明显降低。结论孕期应用HBIG阻断乙肝母婴传播可有效的减少宫内感染率;20周开始免疫和28周开始免疫相比,在临床上,未见明显的优势,但是胎盘感染的微观方面,有明显低的感染率,新生儿外周血能比脐血更准确的诊断乙肝感染情况;羊膜的感染率与胎盘相同。

Objective： More recent stdudie suggest that HBV infecion in uteru may be interrupted by using mutiple HBV specific immunoglobulin （HBIG） intramuscularly before delivery. But the methods are not unified and some fetus were infected however. HBIG were intramusculared on pregnant women of HBV from 20 pregmant week every four weeks, five times together in our study and it was expected a more available and economic method. Results ： There are no evidently difference between 20w and 28w on uteru infection and antibody appearance, but there are statistical difference on infection of placentas. The infection of amnion is consistent with placenta. Periphery vein blood is better than umbilicu vein blood on detection of HBV indicasts.