孕妇乙型肝炎病毒感染与新生儿乙型肝炎基因疫苗免疫效果关系的前瞻性研究

The prospective study on correlation between HBV infection in pregnant women and immune effect of hepatitis B gene vaccine in neonates

目的探讨孕妇乙型肝炎病毒（ＨＢＶ）感染对新生儿乙型肝炎（简称乙肝）基因疫苗免疫接种效果的影响。方法采用酶联免疫吸附试验（ＥＬＩＳＡ）和聚合酶链反应（ＰＣＲ）法对乙肝基因疫苗免疫效果进行了前瞻性研究。结果在新生儿系列血清中均未检出乙型肝炎病毒（ＨＢＶ）ＤＮＡ和血清学感染标志；对照组和感染组新生儿免疫保护率分别为９３％（２８／３０）和８３％（３９／４７）（χ２＝１．７４，Ｐ＞０．０５），两组汉族和少数民族间免疫保护率亦无统计学差异（概率法，Ｐ＝０．９８；χ２＝０．１１，Ｐ＞０．０５）。结论随着接种次数的增加，各组两民族抗ＨＢｓ阳转率均呈现出不同程度的升高，分娩时孕妇ＨＢＶ感染状态对新生儿抗ＨＢｓ阳转率可能产生一定程度的影响。

Objective To explore the effect of maternal HBV infection on neonatal immunization with hepatitis B gene vaccine. Methods Prospective study was used in evaluation of immune effects with ELISA and PCR. Results Hepatitis B virus nucleic acid (HBV DNA) and serologic infectious markers were not found in neonatal series sera. The immunization protective rates in control and infectious group were 93% (28/30) and 83% (39/47), respectively (χ 2=1.74, P >0.05). There were also no statistical significant differences in protective rates among groups or between nationalities (probability, P =0.98; χ 2=0.11, P >0.05). Conclusion The study indicated that anti HBs positive rates in various groups or nationalities increased differently with inoculation times and suggested maternal HBV infectious state at parturition might produce some effects on neonatal anti HBs positive transformation.