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目的了解孕期乙肝免疫球蛋白(HBIG)阻断乙肝病毒宫内感染的疗效。方法选择2009-2010年在我院产科门诊定期产前检查并住院分娩的HBsAg阳性孕妇360例,观察组196例,于孕28、32、36周肌注HBIG 200IU,对照组164例不用药。用酶联免疫吸附试验(ELISA)和荧光定量PCR检测2组新生儿采股静脉血,检测乙肝病毒标志物和HBV-DNA。结果 HBIG对HBsAg单阳性和合并抗-HBe、抗-HBc阳性率分别为6.35%、22.81%和12.50%、32.20%,2组差异有统计学意义(P<0.05)。合并HBeAg、抗-HBc的阳性率为7.25%和16.67%,2组差异无统计学意义(P>0.05)。结论孕妇于孕晚期多次肌注HBIG进行被动免疫,可阻断HBV宫内感染,但HbeAg阳性产妇阻断无明显效果。
Objective To understand the effect of hepatitis B immunoglobulin (HBIG) during pregnancy on the intrauterine infection of hepatitis B virus. Methods A total of 360 cases of HBsAg positive pregnant women and 196 cases of observation group were enrolled in the obstetrics clinic of our hospital during 2009-2010. The HBIGAg positive pregnant women were intramuscularly injected with 200 IU at 28, 32, 36 weeks of pregnancy and 164 cases in the control group without medication. Enzyme-linked immunosorbent assay (ELISA) and real-time quantitative PCR (PCR) were used to detect blood samples collected from newborns in two groups to detect hepatitis B virus markers and HBV-DNA. Results The positive rates of HBIG to HBsAg single positive and combined anti-HBe and anti-HBc were 6.35%, 22.81% and 12.50%, 32.20% respectively. The difference between the two groups was statistically significant (P <0.05). The positive rates of HBeAg and anti-HBc were 7.25% and 16.67%, respectively. There was no significant difference between the two groups (P> 0.05). Conclusions Pregnant women received passive intramuscular injection of HBIG intramuscularly multiple times during the third trimester of pregnancy, which can block HBV intrauterine infection. However, there was no significant effect of HbeAg-positive maternal obstruction.