乙肝疫苗联合HBIG阻断乙型肝炎病毒母婴传播的临床研究

A clinical study on the efficacy of hepatitis B vaccine combining with hepatitis B immunoglobulin in interdicting maternal-fetal transmission of hepatitis B virus

目的研究HBsAg、HBeAg双阳性的母亲孕晚期肌注HBIG(乙肝免疫球蛋白)及婴儿出生后HBIG联合乙肝疫苗对HBV母婴传播及慢性化阻断的效果。方法随机将141名HBsAg、HBeAg双阳性的母亲及所生的新生儿按不同的阻断方法分为3组,在新生儿及12个月龄时,采血清检测HBsAg和抗-HBs,并对结果进行统计分析。结果阻断Ⅱ组和对照组新生儿HBsAg阳性率分别为2.22%和26.00%,差异具有显著性(P<0.005);阻断Ⅱ组和对照组新生儿抗-HBs阳转率分别为33.33%和10.00%,差异有显著性(P<0.005);阻断Ⅰ组、阻断Ⅱ组和对照组的12月龄婴儿HBsAg阳性率分别为8.70%、2.22%和26.00%,差异有显著性(P<0.005);阻断Ⅰ组、阻断Ⅱ组和对照组的12月龄婴儿抗-HBs阳转率分别为78.26%、73.33%和64.00%,差异无显著性(P>0.05)。结论乙肝免疫球蛋白与乙肝疫苗联合免疫可显著提高乙肝疫苗阻断婴儿出生后HBsAg阳转及HBV感染慢性化。

Objective To evaluate the blocking effect of hepatitis B immunoglobulin （HBIG） and immune reagents （HBIG together with HBV vaccine） on maternal-fetal transmission of HBV and its chronicity for late pregnancy with double positive （HBsAg and HBeAg） and their neonates. Methods According to the different methods of interdicting HBV infection, 141 mothers with double positive and their neonates were divided into three groups. HBsAg and anti-HBs were examined in blood samples when infants were newborn and 12 months old. Results In HBIG newborns group Ⅱ and control group, the intrauterine infection rates were 2.22% and 26.00%, respectively, with significant difference （P〈0.005）; the anti-HBs positive-conversion rates were 33.33% and 10.00%, respectively, with significant difference （P〈0.005）. When infants in HBIG newborns group Ⅰ, group Ⅱ and control group were 12 months old, the HBsAg positive rates were 8.70%, 2.22% and 26.00%, respectively, with significant difference （P〈0.005）; the anti-HBs positlve-conversion rates were 78.26%, 73.33% and 64.00%, without significant difference （P〉0.05）. Conclusion Hepatitis B vaccine combining with HBIG can effectively improve the efficacy of HBV vaccine in interdicting HBsAg positlve-conversion and chronic HBV infection in infants.