HBsAg阳性孕妇的早产儿免疫阻断方式

A study of the HBsAg positive pregnant woman's premature infants on the way of immunity interruption

目的:探讨HBsAg阳性孕妇早产儿的免疫阻断方式。方法:所选对象为HBsAg阳性孕妇的早产儿,生后体重达2000g后给予常规免疫,对照组为HBsAg阳性孕妇的足月儿,给予母婴联合免疫,两组婴儿于出生、6月龄及12月龄分别检测乙肝病毒标志物(HBVm)和肝功能。结果:早产儿组HBVm多种模式有隐性感染或再次感染的可能,HBsAb、HBcAb和HBeAb的产生明显低于足月儿组,χ2检验均有显著性差异(P<0.05)。HBsAg阳性孕妇的早产儿用乙肝免疫球蛋白(HBIG)100IU1次不足以中和清除HBV抗原。当早产儿因早产及低体重无法得到全面免疫保护时,喂母乳有可能继续增加HBV感染的机会。两组婴儿丙氨酸氨基转移酶(ALT)比较无显著性差异,P>0.05。结论:建议HBsAg阳性孕妇的早产儿出生24h内给予HBIG100IU肌肉注射,对明确宫内已感染HBV的早产儿采用HBIG200IU肌肉注射,间隔2周重复1次,待体重达预防接种要求后,再按0、1、6月各接种乙肝疫苗(HBvac)10μg,并禁喂母乳。长期监测HBVm的变化,并同时监测肝功能。

Objective： To discuss the way of more effective immunity interruption on HBsAg positive pregnant woman＇s premature infants. Methods： After the body weight to amount to 2 000 grams, the premature infants of HBsAg positive pregnant woman received immune therapy. In control groups the HBsAg positive pregnant woman＇s full - term infants were received combining immune therapy. The hepatitis B virus sign （HBVm） and the liver function in the birth, 6 months and 12 months of age in all of the two groups were separately detected. Results： Many kinds of patterns had the possibility which the silent infection or infects once more in the premature infant group＇s HBVm. The production of HBsAb, HBcAb and the HBeAb obviously was lower than the full - term groups, and the x2 examination had significant difference （P 〈 0. 05） . One time injection of the hepatitis B immunity globulin （HBIG） 100 IU was insufficient to neutralize and scavenge the newborn HBV antigen in premature infants. The premature infants were unable to obtain the comprehensive immunity protection because the premature delivery and the low body weight, to feeds mother＇s milk perhaps increased the opportunity in HBV infection. ALT of two groups had no significant difference, P 〉 0. 05. Conclusion： The HBsAg positive pregnant woman＇s premature infants should be received HBIG the 1001U intramuscular injection in 24 hours after born. The premature infants which have infected HBV should be received HBIG the 200 IU intramuscular injection and duplicate 1 time after two weeks . After the body weight reaches the prophylactic ineculation＇s request, they should be received hepatitis B vaccine （HBvac） 10 ug in 0, 1,6 months separately, and prohibiting to feed mother＇s milk. The changes of HBVm must be monitor for a long time, and monitoring the liver function simultaneously.