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目的探讨孕妇乙肝病毒携带﹙AsC﹚状况、分娩方式及喂养方式对采用乙肝高效人免疫球蛋白(HBIG)和乙肝疫苗(HB疫苗)联合注射阻断乙肝病毒母婴传播及婴儿免疫应答的影响。方法将孕妇分为HBsAg阳性组和HBeAg阳性组,两组新生儿产后12h内注射HBIG和HB疫苗,产后1个月和6个月接受HB疫苗注射。产后12-15个月抽一次婴儿血查抗HBs和HBsAg,共随访257例,对两组婴儿及不同分娩方式和喂养方式婴儿的抗HBs和HBsAg阳性状况进行比较分析。结果母亲HBsAg阳性组和HBeAg阳性组的婴儿免疫应答率及HBsAg阳性率比较差异有统计学意义;剖宫产与阴道分娩的婴幼儿比较无统计学差异;母亲HBsAg阳性组母乳喂养与人工喂养婴儿比较无统计学差异,母亲HBeAg阳性组母乳喂养与人工喂养的婴儿比较差异有统计学意义。结论在相同的HBIG和HB疫苗制剂及规范的注射条件下,母亲HBeAg阳性增加婴幼儿乙肝病毒携带及免疫无﹙低﹚应答,分娩方式对此无影响,母乳喂养有一定影响。
Objective To investigate the effect of hepatitis B virus carrier (AsC) status, mode of delivery and feeding methods on the mother-to-infant transmission and infant’s immune response of hepatitis B virus (HBV) combined with HBIG and HB vaccine. Methods Pregnant women were divided into HBsAg positive group and HBeAg positive group. Two newborns were injected with HBIG and HB vaccine within 12 hours postpartum and were given HB vaccine one month and 6 months after delivery. Anti-HBs and HBsAg were collected from 12 to 15 months postpartum. A total of 257 cases were followed up. The positive rates of anti-HBs and HBsAg in infants and in different modes of delivery and feeding were compared. Results There was significant difference in the rate of infant immunization and the positive rate of HBsAg between mother’s HBsAg positive group and HBeAg positive group. There was no significant difference between cesarean section and vaginal delivery in infants and toddlers. The mothers with HBsAg-positive breastfeeding group and artificial feeding group There was no significant difference between the mother and the HBeAg-positive group of breast-fed and fed-fed infants compared with the difference was statistically significant. Conclusion In the same HBIG and HB vaccine preparations and the standard injection conditions, mothers HBeAg positive increase in infants and young children with hepatitis B virus carriers and no immune (low) response, mode of delivery had no effect on breastfeeding have a certain impact.