孕晚期注射HBIG对HBV产妇母乳安全性的影响

Effect of hepatitis B immune globulin injected during advanced stage of pregnancy on the safety of breast milk in HBV parturient

目的观察孕晚期注射HBIG对母乳HBeAg和HBV DNA阳性率的影响。方法87例HBsAg/HBeAg阳性、HBV DNA阳性、肝功能正常的孕妇分为两组。研究组51例,于孕28、32、36周时肌肉注射HBIG,每次200IU;对照组36例,不注射HBIG。所产新生儿均接受主、被动联合免疫即出生后6h内予HBIG200IU肌肉注射,乙肝疫苗以"0、1、6"方案免疫接种,剂量为10μg。比较两组孕妇治疗前后静脉血、母乳、新生儿脐血及婴儿6个月龄外周血HBeAg、HBV DNA阳性率。结果研究组阻断后母血HBV DNA含量(4.10±1.17)低于对照组(5.25±1.30)(P<0.01)。母乳HBV DNA阳性率5.88%,低于对照组的25%(P<0.05)。结论孕晚期HBIG阻断治疗能降低乙肝病毒宫内传播,提高了产妇母乳的安全性。

Objective To study the effect of hepatitis B immune globulin （HBIG） on the safety of breast milk in HBV parturient. Methods Eighty-seven HBsAg and HBV DNA positive pregnants were divided into 2 groups. Fifty-one cases in study group were injected HBIG（200 IU per time） on the 24th ,28th ,32nd and 36th pregnant week. Thirty-six cases in control group were not injected. All neonates were injected HBIG in 6 hours after born,and HBV vaccine（10 μg） at 24 hours,one month and 6 months. Blood levels of HBeAg and HBV DNA were detected in pregnant women before and after HBIG injection and infant aged 6 months, which were examined in cord blood of neonate and breast milk of parturient. Results The level of HBV DNA after HBIG injection was remarkably lower in study group than that in control group（4.10± 1.17 vs. 5.25± 1.30）（P〈0.05）. So did the positive rate of HBV DNA in the breast milk（5.88% vs. 25%）（P〈0.05）. Conclusion HBIG injection in the parturients carrying HBV can decrease the intrauterine infection of HBV and increase the safety of breast milk.