乙肝表面抗原阳性孕妇肌注乙肝免疫球蛋白预防母婴传播的临床研究

Clinical Study on the Prevention of HBV Transmission from Mother to Infant by Injection of HBIG in Pregnant Women with HBsAg

目的 探讨经母亲对胎儿行被动免疫在预防乙型肝炎病毒(HBV) 宫内感染中的作用。方法 对自孕20 周起多次肌注乙肝免疫球蛋白(HBIG) 的HBsAg( + ) 孕妇34 例(A 组) 及未注射的14 例HBsAg( + ) 孕妇(B 组) ,用固相放免法和套式PCR 检测母血HBsAg 、HBV DNA 及其新生儿血HBsAg 、抗HBS、HBV DNA。结果 A 组35例新生儿中32 例血清抗HBS( + ) ,与B 组相比具有显著差异( P < 0-05) 。A 组新生儿血HBsAg 、HBV DNA 检出率均明显低于B 组。A 组孕妇用药后血HBsAg 滴度及HBVDNA 水平较用药前明显下降。结论 经母亲对胎儿行被动免疫可有效预防HBV 宫内感染。

Objective\ To investigate the effect of passive immunization of fetus by injection of mother with HBIG on prevention of HBV intrauterine infection.Methods\ Forty-eight pregnant women with HBsAg positive were divided into two groups:group A(34 cases)were injected with HBIG during pregnancy;group B(14 cases)were followed up without injection of HBIG as controls.The blood samples of mothers and their infants were tested with radioimmunosassay and PCR.Results\ Of 35 infants in group A,32(91.42%)were positive for anti-HBs,but 2 infants in-group B(14 3%) were positive for anti-HBs(P<0 005).The infants with HBsAg positive and HBV DNA positive in group A were fewer than those in group B(P=0 02and<0 05).Conclusion\ Passive immunization of fetus by injection to mother with HBsAg may prevent HBV intrauterine infection effectively.