海南省澄迈县乙型肝炎病毒母婴阻断策略效果

Effect evaluation of implementing strategy of maternal and infant block on preventing hepatitis B virus infection in Chengmai

目的评价澄迈县乙型肝炎病毒母婴阻断策略的实施效果。方法利用妇幼保健信息系统收集横断面资料;对全县2014年10月1日至2015年9月30日期间住院分娩的完全采取阻断策略的HBs Ag阳性产妇及其分娩的8~12月龄婴儿进行采血,使用乙肝病毒标志物-胶体金法检测乙肝病毒标志物。结果全部157例母婴样本中,婴儿HBs Ag阳性率为2.5%(4例),母婴阻断成功率为97.5%,婴儿HBs Ab阳性率为69.5%(109例),婴儿乙肝病毒标志物检测全为阴性率为28.0%(44例),4例HBs Ag阳性婴儿的母亲HBs Ag和HBe Ag均为阳性,与单纯HBs Ag阳性母亲相比差异有统计学意义(P=0.019)。结论澄迈县乙型肝炎病毒母婴阻断策略落实到位,有效的阻断乙肝病毒母婴传播的风险。在现行母婴阻断策略下,更应关注HBs Ag和HBe Ag均为阳性孕产妇的母婴阻断防控和婴儿免疫无应答情况的改善。

Objective To evaluate the effect of implementing the strategy of maternal and infant block on preventinghepatitis B virus infection in Chengmai County. Methods The cross-section data were collected from the System of Womenand Children＇s Health Information. The HBs Ag positive mothers who had accepted the maternal and infant block strategy ofpreventing hepatitis B virus infection were selected as research subjects when they were delivered during the period of October1,2014 to September 30,2015,and their 8-12 months old infants were also selected as the research subjects. Their bloodsamples were collected and detected for hepatitis B markers with the hepatitis B virus markers-colloidal gold method. Results In 157 pairs of mothers and infants sampled,the positive rate of HBs Ag of infants was 2.5%（4 cases）,and the blockingsuccessful rate of mothers and infants was 97.5%. The positive rate of HBs Ab of infants was 69.5%（109 cases）,and thenegative rate of hepatitis B markers of infants was 28.0%（44 cases）. The mothers（4 cases） whose infants were HBs Ag positivewere both HBs Ag positive and HBe Ag positive,and there was a significant difference between them and the mothers with onlyHBs Ag positive（P=0.019）. Conclusion The strategy of maternal and infant block on preventing hepatitis B virus infectionhas been fully implemented and achieved remarkable results in Chengmai County. We can effectively prevent hepatitis B virusfrom spreading from mother to infant,and we should pay more attention to the prevention and control work for the pregnant andpuerperal women with both HBs Ag positive and HBe Ag positive as well as the immune nonresponsiveness situation of infants.