孕期注射乙肝免疫球蛋白与新生儿HBV宫内感染关系的研究

The association between administration of HBIG during pregnancy and intrauterine infection of HBV

目的探讨孕期注射乙肝免疫球蛋白(hepatitis B immunoglobulin,HBIG)对乙型肝炎病毒(hepatitis B virus,HBV)宫内感染的保护作用。方法以315例乙型肝炎表面抗原阳性、孕期注射过HBIG的孕妇及其新生儿为干预组;以402例乙型肝炎表面抗原阳性、孕期未注射过HBIG的孕妇及其新生儿为对照组,通过比较两组HBV宫内传播发生率,探讨HBIG的保护作用;同时通过分析HBIG对干预组HBsAg滴度、HBVDNA载量的影响,探讨其预防机制。结果干预组有15例新生儿发生宫内感染,对照组有15例发生宫内感染,两组无统计学差异。相关分析显示孕期HBIG注射剂量与HBVDNA拷贝数、HBsAg滴度无关(P>0.05)。结论本研究未发现孕期注射HBIG对HBV宫内传播具有保护作用,也未发现孕期注射HBIG能降低孕妇病毒载量。

Objective To study the protective effect of HBIG administered during pregnancy against HBV intrauterine infection and its mechanism. Methods 315 HBsAg positive pregnant women who were consecutively recruited and were administered with HBIG were selected as intervention group. 402 consecutively recruited HBsAg positive pregnant women without being administered with HBIG were selected as controls. The incidence of HBV intrauterine transmission was compared between the two groups. Titers of HBsAg and copies of HBV DNA in maternal sera of intervention group were detected to explore its mechanism of prevention. Results Fifteen neonates in the intervention group and another 15 in the control group were detected as having HBV intrauterine infection and the difference was insignificant by chi-square test. There was no significant relationship between the titer of HBsAg or copies of HBV DNA and the frequency of HBIG administration with R - value 0.039 or 0.012 respectively （ P 〉 0.05 ）. Conclusions HBIG administration during pregnancy does not decrease the titer of HBsAg or copies of HBV DNA, and no protective effect on HBV intrauterine infection has been observed.