产前注射乙型肝炎免疫球蛋白阻断乙型肝炎病毒宫内感染

Block HBV intrauterine infection by injection of HBIG during pregnancy

目的：评估乙型肝炎（乙肝）免疫球蛋白（ＨＢＩＧ）阻断ＨＢｓＡｇ阳性孕妇乙肝病毒宫内传播的效果。方法：ＨＢＩＧ组２２例，分２组（各１１例），均孕ｗｋ２８起予ＨＢＩＧ２００ＩＵ，ｉｍ，Ａ组每３ｗｋ一次，Ｂ组每４ｗｋ一次，均至分娩为止；对照组２３例，不用上述药物。ＨＢＩＧ组每次用药前、分娩前，对照组孕ｗｋ２８及分娩前检测静脉血ＨＢｓＡｇ，ＨＢｅＡｇ，ＨＢＶ＿ＤＮＡ，新生儿出生后检测ＨＢｓＡｇ，ＨＢＶ＿ＤＮＡ。结果：ＨＢＩＧ组孕妇血ＨＢｓＡｇ，ＨＢＶ＿ＤＮＡ明显下降（Ｐ＜０．０５），ＨＢｅＡｇ无明显变化（Ｐ＞０．０５）。新生儿ＨＢｓＡｇ阳性率明显低于对照组（Ｐ＜０．０５），２组ＨＢＶ＿ＤＮＡ阳性率差别无显著意义（Ｐ＞０．０５），未发现孕妇及新生儿不良反应。结论：产前应用ＨＢＩＧ可降低乙肝病毒宫内感染率。

AIM: To study the effect on HBV intrauterine infection by injection of hepatitis B immunoglobulins (HBIG) during pregnancy. METHODS: Twenty_two patients were divided into group A(11) and group B(11) who were treated with HBIG 200 IU every 3 wk or every 4 wk im from wk 28 respectively. Other 23 patients in control group were without HBIG. The levels of HBsAg, HBeAg and HBV_DNA of mothers were studied every time before injection and delivery in HBIG group, 28 wk and before delivery in control group. The HBsAg, HBV_DNA of newborns were studied after birth. RESULTS: HBsAg, HBV_DNA levels of the mothers in HBIG group decreased significantly after treatment (P<0.05), but HBeAg did not. The HBsAg positive rate of the newborns in HBIG group is much lower than that of control group (P<0.05), but HBV_DNA positive rate has no significant difference (P>0.05). No adverse reactions were discovered on mothers and newborns. CONCLUSIONS: The HBV intrauterine infection could be decreased by using HBIG during pregnancy.