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目的 探讨孕妇主动与被动联合免疫预防乙型肝炎病毒 (H BV)宫内感染的作用和机理。 方法 将 5 3例 H Bs Ag(+)孕妇分成两组 ,预防组 30例 ,自孕 2 0周起多次注射乙肝疫苗(HBVac)和乙肝免疫球蛋白 (HBIG) ;对照组 2 3例 ,不用 HBVac和 HBIG。母儿血清 HBs Ag、HBe Ag和抗 - HBs用固相放免法检测 ,HBV- DNA用套式 PCR检测。 结果 预防组新生儿血清 HBs Ag和HBV - DNA检出率明显低于对照组 (3.3%与 2 6 .1% ,10 %与 34 .8% ) P均 <0 .0 5 ;预防组新生儿抗 -HBs阳性率显著高于对照组 (33.3%与 8.7% ) P<0 .0 5。 结论 孕妇于孕期通过 HBIG和 HBV ac免疫 ,可有效预防 HBV宫内感染 ,其机理可能为胎儿获得被动免疫。
Objective To investigate the role and mechanism of active and passive pregnant women in preventing intrauterine infection of hepatitis B virus (H BV) in pregnant women. Methods Fifty-three pregnant women with H Bs Ag (+) were divided into two groups. The prevention group consisted of 30 patients. HBVac and HBIG were injected repeatedly 20 weeks after pregnancy. In the control group, No HBVac and HBIG. Maternal and neonatal serum HBs Ag, HBe Ag and anti-HBs were detected by solid-phase radioimmunoassay, and HBV DNA was detected by nested PCR. Results The detection rates of serum HBsAg and HBV - DNA in neonates with prevention group were significantly lower than those in control group (3.3% vs 26.1%, 10% vs 34.8%, P <0.05). Neonates The positive rate of anti-HBs was significantly higher than that of the control group (33.3% vs 8.7%) (P <0.05). Conclusion Pregnant women were immunized with HBIG and HBV ac during pregnancy, which could effectively prevent HBV intrauterine infection. The mechanism may be passive immunization of fetus.