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为了解宫内受乙型肝炎（简称乙肝）病毒（ＨＢＶ）感染婴儿接种乙肝疫苗导致免疫失败的机理和预后，用植物血凝素（ＰＨＡ）作淋巴细胞增殖试验，用ＨＢＶ前Ｓ２多肽特异性扩增ＨＢＶＤＮＡＳ区基因并分析其变异情况。对４９７名携带ＨＢＶ母亲所生新生儿单纯接种乙肝疫苗，并对携带ＨＢＶ母亲产前注射免疫球蛋白（ＨＢＩＧ）（妇产组）；对携带ＨＢＶ产前不注射ＨＢＩＧ母亲所生４９０名新生儿生后注射ＨＢＩＧ加乙肝疫苗（中山组）。两组均随访４～６年。结果显示，妇产组ＨＢＶ的宫内感染率为１４．３％，中山组ＨＢＶ的宫内感染率为５．７％；淋巴细胞增殖试验显示宫内感染ＨＢＶ后其细胞免疫功能不足，Ｔ淋巴细胞对ＨＢＶ的特异性刺激源处于免疫耐受状态。孕妇产前多次注射ＨＢＩＧ能有效减少ＨＢＶ的宫内感染；在受宫内ＨＢＶ感染的儿童中存在着乙肝病毒变异，感染变异病毒是接种乙肝疫苗免疫失败的重要原因，并易发展为慢性乙型肝炎
In order to understand the mechanism and prognosis of immune failure caused by intrauterine infection of hepatitis B virus (HBV) -infected infants with hepatitis B vaccine, phytohemagglutinin (PHA) was used to test lymphocyte proliferation. HBV preS2 peptide-specific HBVDNAS gene was amplified and analyzed for variation. A total of 497 newborns born to HBV mothers were given hepatitis B vaccine alone and were given HBV mothers prenatal immunoglobulin (HBIG) (maternal group). 490 newborns After birth, HBIG plus hepatitis B vaccine (Zhongshan Group). Both groups were followed up for 4 to 6 years. The results showed that the intrauterine infection rate of HBV in the maternity group was 14.3% and the intrauterine infection rate of HBV in Zhongshan group was 5.7%. The lymphocyte proliferation test showed that the intrauterine infection of HBV had insufficient cellular immunity, Cells to HBV-specific stimuli in the immune tolerance state. Multiple injections of HBIG into pregnant women can effectively reduce the intrauterine infection of HBV; HBV mutation exists in children with intrauterine HBV infection. Infectious variant virus is an important cause of immune failure in hepatitis B vaccination, and it is easy to develop into chronic B Hepatitis