不同方法注射乙型肝炎免疫球蛋白阻断乙型肝炎病毒母婴传播的临床研究

目的探讨乙型肝炎病毒(HBV)阳性的孕妇用不同方法注射乙型肝炎免疫球蛋白(HBIG)预防HBV宫内感染的作用效果。方法将2009年6月～2010年11月在产科门诊孕检的孕妇表面抗原阳性的孕妇300例随机分为2组,研究组150例,分别于孕24、28、32、36周足三里穴位注射乙型肝炎免疫球蛋白(HBIG)共4次,每次200IU;对照组150例,同时间、同剂量应用HBIG。采用酶联免疫法,检测用药前、后孕妇血清及新生儿脐血清的乙肝二对半,采用核酸扩增(PCR)荧光定量法检测HBV-DNA含量。结果研究组宫内感染率7.3%,对照组宫内感染率18.6%,两组比较有显著差异。研究组用药后HBV-DNA滴度比对照组明显下降,特别是大三阳及HBsAg、HBeAb阳性的孕妇。新生儿脐血清HBsAb检测率:研究组HBsAb检测率63.3%(95/150),明显高于对照组HBsAb检测率45.3%(68/150)。结论孕妇通过足三里穴位注射HBIg,可有效降低乙肝病毒DNA的滴度,减少HBV的宫内感染,未发现任何副作用。

Objective The goal discussion hepatitis B virus（HBV） masculine pregnant woman prevents the function effect which with different method injection hepatitis B immune globulin（HBIG）（HBIG） in the HBV palace infects.Methods In pregnant the examining pregnant woman surface antigen masculine pregnant woman 300 examples June,2009 to November,2010 in my courtyard obstetrics outpatient service to divide into two groups stochastically,the study team 150 examples,in is pregnant separately 24,28,32,36 week foot three mile acupuncture point injection hepatitis B immune globulin（HBIG）（HBIG） altogether 4 times,each time 200IU;The control group 150 examples,the meantime,the same dosage applies HBIG.Uses the enzyme to unite the immunization,the examination applies drugs the before and after pregnant woman blood serum and the newborn navel blood serum＇s hepatitis B two fifty-fifty,uses the nucleic acid to increase the（PCR） fluorescence quota law to examine the HBV-DNA content.Results The study team,in the palace the infection percentage 7.3%,in the control group palace the infection percentage 18.6% two groups of comparisons have the remarkable difference.After study team medication,the HBV-DNA titer is more obvious than the drop the control group,specially big three positive and HBsAg,HBeAb masculine pregnant woman.Newborn navel blood serum HBsAb examination rate：The study team HBsAb examination rate 63.3%（95/150） is higher than the control group HBsAb examination rate 45.3%68/150.Conclusion The pregnant woman injects HBIg through the foot three miles acupuncture points,but reduces hepatitis B virus DNA effectively the titer,reduces HBV in the palace to infect,has not discovered any side effect.