孕期应用乙型肝炎免疫球蛋白在阻断乙型肝炎母婴传播中的效果分析

Application of Hepatitis B Immune Globulin in Pregnancy Blocking Effect of Hepatitis B in the Analysis of Mother to Child Transmission

目的分析并评价乙型肝炎免疫球蛋白对孕期乙型肝炎宫内感染的预防效果,评价孕期采用乙型肝炎免疫球蛋白在控制乙型肝炎母婴传播方面的可行性。方法对我院自2009年7月至2010年12月期间进行乙型肝炎母婴阻断,在产科定期行产检并分娩的HBsAg阳性,同时HBV-DNA也为阳性的母亲和新生儿共198例,按照孕期肌内注射乙型肝炎免疫球蛋白前后母血HBV-DNA变化情况进行分组:一组为HBV-DNA转阴者;二组为HBV-DNA下降者(不包括转阴组);三组为HBV-DNA升高者。对三组新生儿免疫效果进行评价。结果经多次肌内注射乙型肝炎免疫球蛋白后,82%(162/198)的孕妇静脉血HBV-DNA含量总体出现下降,其中有4.95%(10/198)的孕妇HBV-DNA出现转阴,有18%(36/198)孕妇HBV-DNA含量上升。一组10例与二组152例的新生儿免疫失败率均为0,而三组36例新生儿免疫失败率为25.00%,组间比较差异显著(P<0.01),具统计学意义。结论参考孕期肌内注射乙型肝炎免疫球蛋白前后母血HBV-DNA拷贝数变化情况能够有效预测新生儿免疫失败的概率。

Objective To analyze and evaluate hepatitis B immune globulin for the prevention of intrauterine infection of hepatitis B during pregnancy results, the evaluation of hepatitis B immune globulin in pregnancy using maternal transmission of hepatitis B control feasibility. Methods The hospital from July 2009 to December 2010 period for hepatitis B PMTCT, the line regularly for check-in obstetric and delivery of HBsAg-positive, and HBV-DNA for positive mothers and newborns were 198 cases by intramuscular injection of hepatitis B immune globulin during pregnancy, maternal serum HBV-DNA before and after changes to group： a group of HBV-DNA negative persons; two groups of HBV-DNA decrease （not including the negative group）; three groups of HBV -DNA elevated. Of the three groups to evaluate the effect of neonatal immunity. Results After repeated intramuscular injection of hepatitis B immune globulin, the 82% （162/198） of the HBV-DNA content of blood of pregnant women overall decline, of which 4.95% （10/198） of pregnant women appear negative HBV-DNA, 18% （36/198） of pregnant women HBV-DNA levels increased. A group of 10 patients with two groups of 152 cases of neonatal immune failure rates were 0, and the three group of 36 cases of neonatal immune failure rate of 25.00%, a significant difference between groups （P〈0.01）, with statistical significance. Conclusion Reference pregnancy intramuscular injection of hepatitis B immune globulin before and after maternal HBV-DNA copy number variation can effectively predict the probability of failure of neonatal immunity.