乙肝特异性免疫球蛋白联合乙肝疫苗阻断乙肝母婴传播的实验研究

Epidemiologic Experimental Study of HBIG and HBV Vaccines on Blocking Hepatitis B Virus Infection Mother to Infant Transmission

目的:应用乙肝疫苗和乙肝特异性免疫球蛋白(简称乙肝特免)阻断乙肝母婴传播,比较不同方法阻断效果,探索较好的乙肝母婴阻断方式。方法:本研究采取流行病学实验方法。在孕妇中筛选乙肝病毒感染者,将乙肝病毒感染母亲所生婴儿随机分组,一组(A组)在婴儿出生后使用乙肝疫苗和乙肝特免,另一组(B组)婴儿出生后只使用乙肝疫苗,不使用乙肝特免。两组婴儿出生后都按照国家免疫程序接种乙肝疫苗。两组婴儿在l岁和2岁时分别检测乙肝相关标志物,判定乙肝病毒感染情况。在3岁时采集2岁HBsAg阳性者的血清进一步做乙肝标志物和HBVDNA监测。结果:128名婴儿完成了实验,1岁时检测HBsAg和HBsAb,阳性率分别为24.2%和97.66%,2岁阳性率分别为53%和97.66%,3岁时确定了4例乙肝病毒感染者,其中,A组(接种疫苗加乙肝特免组)l例,感染率为l,75%(1/57),B组(单纯接种疫苗者感染)3例,感染率为4.23%(3/71)。A组感染率低于B组。保护率为58.48%,绝对危险度降低25%。结论:乙肝特免和乙肝疫苗联合使用能提高乙肝母婴传播的阻断率。

Objective：To compare the effects of hepatitis B vaccine and hepatitis B immune globulin（HBIG） on blocking hepatitis B from mother to infant transmission,and to explore the optimal method of blocking the mother-to-child transmission.Methods：The epidemiologic experimental methods are used in the study.The pregnant women who infected with HBV were selected,and their babies randomly divided into two groups：group A and group B.In the group A,the infants were injected Hepatitis B immune globulin and HBV vaccines. In the group B,the infants were just injected HBV vaccines.According to the vaccine immunization schedule in China,the infants in the two groups were vaccinated HBV vaccines after born.The HBV markers were detected at the time of the infants one and two years old to determine the HBV infection situation.When infants with HBsAg positive at 2 years old reached 3 years old, the further detection of HBsAg markers and HBV-DNA were taken. Results： 128 infants took part in this study.The positive rate of HBsAg and HBsAb are 24.2% and 97.66% when the infants were lyear old,The positive rate of HBsAg and HBsAb are 5.3% and 97.66% when the infants were 2 years old.When the infants were 3 years old,4 children were confirmed to be HBV infective patients,and there had 1（1.75%） cases in the group A and 3 cases （4.11%） in the group B.Conelusion：Combined use of hepatitis B vaccine and hepatitis B immune globulin（HBIG） can increase the blocking rate of hepatitis B virus infection from mother to infant.