不同方案阻断乙型肝炎病毒母婴垂直传播的随访观察

Clinical study on prevent mother-infant vertical transmission of hepatitis B virus

目的 探讨阻断乙型肝炎病毒母婴垂直传播的方法。方法 将 4 88例HBsAg阳性孕妇分成四组 ,单纯HBVac治疗组 116例 ,单纯HBIG治疗组 116例 ,左旋咪唑涂布剂加两者联合应用 12 0例 ,未治疗组 136例。治疗组均在孕 2 6周起开始注射 ,孕妇和新生儿血清HBsAg、抗 -HBs、HBeAg、抗 -HBe、抗 -HBc检测采用ELISA法。随访产妇及新生儿的乙肝标志物(HBVM)变化。结果 脐血中HBsAg阳性率 :HBVaC治疗组为 18.10 % ,HBIG治疗组为 9% ,联合治疗组为 3.33% ,未治疗组为2 4 .2 6 %。随访母亲HBVM多数转为HBSAg、抗 -HBC、抗 -HBc阳性 ,所生儿童抗 -HBs>70 %。结论 携带HBV孕妇于孕晚期给予HBVac、HBIG和左旋咪唑涂布剂联合两者治疗后 ,可有效阻断HBV母婴之间传播。

Objective: To probe into prevent methods on mother-infant vertical transmission of Hepatitis B virus.Methods: 488 cases chronic HBsAg carriers pregnant women were divided into four groups. 116 cases were injected with hepatitis B vaccine, 116 cases were injected with hepatitis B immunoglobulin: l20 cases were injected combined with both add levamisole liniment during pregnancy since the 26th week of gestation. There were l36 cases without injection of HBVac or HBIG and other. Serologic HBV markers (HBsAg. HBsAb.HBeAg. HBeAb. HBcAb) of pregnant women and newborns umbilical blood were detected bv ELISA.These women were divided into two guoups by delivery manier. Results: HBsAg positive rate of newborns umbi1ical blood were 9.10%. 9.48% and 3.33% with different treatments (HBVac. HBIG. HBVac and HBIG add levamisole liniment.),respectively. Conclusion: Immunization with HBVac or HBlG or both add levamisole liniment during pregnany may prevent intrauterine HBV infection effectiveIy.