预防免疫对乙型肝炎父婴传播的初步研究

Immunization in prevention of paternal-fetal transmisson of Hepatit is B virus

目的 探讨预防乙型肝炎病毒 (HBV )父婴传播 (P FT)的方法。方法 选取 1996年 1月至 2 0 0 2年12月 3 1例孕妇丈夫血清HBVDNA(+ )、孕妇无HBV感染的病例 ,孕前以乙肝疫苗 (HBVac)免疫至抗 HBs(+ )后再妊娠 ,自孕 2 0周起 ,每 4周肌注乙肝免疫球蛋白 (HBIG ) 2 0 0IU至产前 (观察组 )。另筛选入院时发现孕妇无HBV感染 (乙肝两对半各指标全阴性 ) ,而丈夫血清HBVDNA (+ )的 2 6例夫妇作对照组 ,两组病例产时均取脐带血查HBVDNA ,及抗 HBs ,观察两组新生儿HBV感染率及抗 HBs(+ )率。结果 观察组新生儿HBV感染率为 16 13 % (5/3 1) ,而对照组感染率为 42 3 1% (11/2 6) ;观察组新生儿抗 HBs(+ )率为 54 84% (17/3 1) ,对照组为 0 (0 /2 6)。观察组的HBV感染率显著低于对照组 (P <0 0 5)。结论 孕前肌注乙肝HBVac、孕期肌注HBIG可有效预防HBV的P FT。

Objective To investigate the interruptive effect of blocking the paternal-fetal transmiss ion of hepatitis B virus(HBV). Methods From January 1996 to December 2002,57 couples of men with serum HBV-DNA positiv e and women without HBV infection were selected and assigned to study group (grou p A,31 couples) and a control group (group B,26 couples).Each woman in group A was successfully vaccinated with hepatitis B vaccine(HBVac)before pregnancy and injected with hepatitis B specific immunoglobulin(HBIG)monthly during pregna ncy;those in group B did not receive any specific treatment.The anti-HBs an d HBV DNA of the neonates were determined after birth by testing the serum of cor d blood. Results 54 84%(17/31) of infants in group A and none in group B were positive of anti- H Bs;16 13% (5/31) of neonates in group A and 42 31%(11/26) of neonates in group B were infected by HBV,the infection rate of HBV in group A(0/26)was significan tly lower than that in group B(P<0 05). Conclusion The paternal-fetal transmission of HBV may be effectively interrupted by using active/passive immunization before delivery.