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目的了解贵州省乙肝表面抗原筛检阳性孕妇的新生儿乙肝病毒感染情况。方法采用分层随机抽样的方法,随机抽取4个市州,在4个市州中随机抽取9个县级医院作为调查单位,对调查单位内2014-01/2015-12期间住院分娩的孕妇开展乙肝病毒表面抗原(Hepatitis B Surface Antigen,HBs Ag)筛查,对HBs Ag阳性的孕妇及其新生儿开展问卷调查并采集静脉血及脐带血标本,分离血清后用酶联免疫吸附试验(ELISA)检测HBs Ag、抗乙肝病毒表面抗原抗体(Antihepatitis B Surface Antibody,Anti-HBs)、抗乙肝病毒核心抗原抗体(Anti-hepatitis B Core Antibody,Anti-HBc)。对HBs Ag阳性标本进行乙肝病毒e抗原(Hepatitis B e Antigen,HBe Ag)和抗乙肝病毒e抗原抗体(Anti-hepatitis B e Antibody,Anti-HBe)。结果孕妇HBe Ag阳性占40.29%,HBs Ag、HBe Ag双阳性者占38.68%;527名新生儿中,33.97%为HBe Ag阳性,20.30%为HBs Ag、HBe Ag双阳性。孕妇感染HBV模式有20种,大三阳和小三阳占65.10%,新生儿HBV感染模式有23种,大三阳和小三阳占新生儿数的30.70%;162名大三阳孕妇所生新生儿中有56.79%为大三阳,203名小三阳孕妇所生新生儿中有35.47%为小三阳。结论孕妇HBs Ag、HBe Ag双阳性以及大、小三阳感染模式是贵州省HBV母婴传播防控的重点人群。对重点人群所产新生儿应在出生后12h内,肌内注射1针乙肝免疫球蛋白,同时按0、1、6个月3针方案接种乙型肝炎疫苗,切断HBV母婴传播。
Objective To understand the status of hepatitis B virus infection in newborns with positive hepatitis B surface antigen screening in Guizhou Province. Methods Stratified random sampling method was used to randomly select 4 cities and prefectures, randomly selected 9 county-level hospitals in 4 cities and prefectures as the investigation units, carried out in-hospital delivery of pregnant women within the investigation unit between 2014-01 / 2015-12 Hepatitis B surface antigen (HBsAg) screening, HBsAg positive pregnant women and their newborns to carry out a questionnaire survey and blood and cord blood samples were collected, the serum was separated by enzyme-linked immunosorbent assay (ELISA) HBsAg, Antihepatitis B Surface Antibody (Anti-HBs) and Anti-hepatitis B Core Antibody (Anti-HBc) were detected. HBs Ag positive specimens were subjected to Hepatitis B e Antigen (HBeAg) and Anti-hepatitis B e Antibody (Anti-HBe). Results The positive rate of HBeAg in pregnant women was 40.29%, and the positive rate of HBsAg and HBeAg was 38.68%. Among 527 newborns, 33.97% were positive for HBeAg and 20.30% were HBsAg and HBeAg positive. There are 20 kinds of HBV infection in pregnant women, 65.10% in Big Sanyang and Small Sanyang, 23 kinds in HBV infection in newborns, 30.70% in Big Sanyang and Small Sanyang, 162 freshmen in Big Sanyang pregnant women There are 56.79% of children as big Sanyang, 203 Sanyang pregnant women born in 35.47% of newborn babies. Conclusion The double positive HBsAg and HBe Ag in pregnant women and the pattern of big and small triple positive infection are the key population of prevention and control of mother-to-child transmission of HBV in Guizhou province. Newborn infants born in the key population should be intramuscularly injected with 1 dose of hepatitis B immunoglobulin within 12 hours after birth, and at the same time, the Hepatitis B vaccine should be inoculated according to the 3-needle regimen of 0, 1 and 6 months to cut off the mother-to-child transmission of HBV.