乙肝免疫球蛋白联合乙肝疫苗阻断HBV母婴传播的效果观察

Effects of hepatitis B immunoglobulin combined with hepatitis B vaccine on blocking HBV mother-to-child transmission

目的探究乙肝免疫球蛋白联合乙肝疫苗阻断乙肝病毒(HBV)母婴传播的效果。方法选择2014年8月至2015年10月我院收治的HBs Ag阳性孕妇380例,根据随机数字表法将所有孕妇分为对照组与观察组,每组190例。对照组仅给予新生儿接种乙肝疫苗,观察组孕妇和新生儿均接种乙肝免疫球蛋白联合乙肝疫苗。比较两组胎儿宫内与1年后HBV感染情况和新生儿出生时及其1年后HBsAb阳性情况。结果观察组胎儿宫内HBV感染率为9.47%(18/190),新生儿出生1年后HBV感染率为1.58%(3/190),均低于对照组的22.63%(43/190)及16.32%(31/190),差异有统计学意义(P<0.05);观察组新生儿出生时与1年后HBsAb阳性率分别28.42%、94.21%,均高于对照组的7.89%、76.32%,差异有统计学意义(P<0.05)。结论孕妇和新生儿均接种乙肝免疫球蛋白联合乙肝疫苗,能有效降低新生儿HBV感染率,提高新生儿HBsAb阳性率和HBV的传播阻断率。

Objective To investigate the effects of hepatitis B immunoglobulin （HBIG） combined with hepatitis B vaccine on blocking hepatitis B virus （HBV） mother-to-child transmission. Methods From August 2014 to October 2015, 380 cases of pregnant women with positive HBsAg in our hospital were divided into control group and observation group by random number table, with 190 cases in each group. The newborns of the control group were given hepatitis B vaccine, while the pregnant women and newborns of the observation group were given HBIG combined with hepatitis B vaccine. The fetus HBV infection in uterus and 1 year after birth and the positive HBsAb rate of newborns at birth and after 1 year of the two groups were compared. Results The intrauterine HBV infection rate of fetus in the observation group was 9.47% （18/190）, and the HBV infection rate of newborns after birth for 1 year in observation group was 1.58% （3/190）, which were lower than 22.63% （43/190） and 16.32% （31/190） in the control group （P〈0.05）; the positive HBsAb rate of newborns at birth and after 1 year in the observation group were 28.42% and 94.21%, which were higher than 7.89% and 76.32% in the control group （P〈0.05）. Conclusion HBIG combined with hepatitis B vaccine inoculation in pregnant women and newborns can ef- fectively decrease HBV infection rate and increase positive HBsAb rate of newborns, and increase blocking rate of HBV transmission.