孕期注射乙肝免疫球蛋白阻断HBV宫内感染及对婴儿产生anti-HBs的影响

Blocking HBV intrauterine infection by injection of hepatitis B immunoglobulin during gestational period and the effect on production of anti-HBs in infants

目的:探讨孕期注射乙肝免疫球蛋白(hepatitis B immunoglobulin,HBIG)对HBV母婴传播的影响及婴儿对乙肝疫苗免疫应答情况。方法:以HBsAg阳性孕妇及其新生儿为研究对象,孕期注射乙肝免疫球蛋白的孕妇300例及新生儿为实验组,未使用者80例为对照组,比较两组新生儿宫内感染率及出生时和7个月抗体产生情况。结果:孕期注射HBIG组与未注射组新生儿宫内感染率分别为5.33%(16/300)和1.25%(1/80),差异无统计学意义(χ2=2.464,P>0.05);孕期注射HBIG组与未注射组新生儿出生时anti-HBs阳性率分别为10.33%(31/300)和1.25%(1/80),差异有统计学意义(χ2=6.757,P<0.05),7个月龄anti-HBs产生率为96.12%(124/129)和95.35%(41/43),差异无统计学意义(χ2=0.049,P>0.05);出生时anti-HBs阳性的新生儿25例,7个月复查均产生anti-HBs,而出生时anti-HBs阴性或弱阳性的147例婴儿,7个月复查有7例婴儿anti-HBs仍为阴性或弱阳性,但差异无统计学意义(χ2=0.321,P>0.05)。结论:孕期注射HBIG不能降低HBV宫内感染率,可提高新生儿出生时anti-HBs阳性率,但对7个月anti-HBs产生率无影响。

Objective： To explore the effect of injection of hepatitis B immunoglobulin （HBIG） during gestational period on mater- nal -infantile transmission of hepatitis B virus （HBV） and immune response of infants to HBV vaccine. Methods： The pregnant women with positive HBsAg and their neonates were selected as research objects, 300 pregnant women who were treated with injection of HBIG dur- ing gestational period and their neonates were selected as experimental group, and 80 pregnant women who didnl receive the treatment and their neonates were selected as control group ; the incidence rates of intrauterine infection of neonates and the productions of HBV antibodies at seven months after birth were compared between the two groups. Results： The incidence rates of intrauterine infection in experimental group and control group were 5.33% （16/300） and 1.25% （1/80）, respectively, there was no statistically significant difference between the two groups （X2 = 2. 464, P 〉 0. 05 ） , The positive rates of HBsAb of neonates at birth in experimental group and control group were 10. 3% （31/300） and 1.25% （ 1/80）, respectively, there was statistically significant difference between the two groups （X2 =6. 757, P 〈 0. 05） ; the production rates of HBsAb in experimental group and control group at seven months after birth were 96. 12% （124/129） and 95.35% （41/43）, respectively, there was no statistically significant difference between the two groups （X2 =0, 049, P 〉0. 05） ; 25 neo- nates were found with positive HBsAb at birth and at seven months after birth; while among 147 neonates with negative or weak positive HB- sAb at birth, 7 neonates were found with negative or weak positive HBsAb at seven months after birth, but there was no statistically signifi- cant difference （X2 = 0. 321, P 〉 0. 05 ） . Conclusion： Injecting HBIG during gestational period can＇t reduce HBV intrauterine infection rate, while it can raise the positive rate of HBsAb at birth, but the method has no impact on production rate of HBsAb at seven months after birth.