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目的了解北京市朝阳区团结湖社区2006-2012年50例实施乙型肝炎(乙肝)母婴阻断的效果。方法选取2006-2012年在北京市朝阳区团结湖社区卫生服务中心保健科进行预防接种及随访管理的49名乙型肝炎病毒表面抗原(HBsAg)阳性母亲所生的50名婴儿(双胞胎1例)作为调查对象。收集整理调查对象基本情况、母亲和婴儿接受母婴阻断情况、乙型肝炎病毒感染情况、产后追访情况等。采用SPSS16.0统计软件进行数据描述分析。结果 49名HBsAg阳性母亲中,仅HBsAg阳性者46人;HBsAg和HBeAg均阳性者2人;HBsAg、DNA、ALT均阳性者1人。年龄为20~34岁44人,占89.8%;文化程度为大专及以上29人,占59.2%。49名HBsAg阳性母亲在孕期使用乙肝免疫球蛋白进行乙肝阻断者4名(HBsAg单阳性2名,HBsAg、HBeAg双阳性1名,HBsAg、DNA、ALT均阳性者1名)。其余45名在孕期均未进行乙肝母婴阻断的干预(孕期未注射乙肝免疫球蛋白)。50名婴儿出生后24h、满1个月和6个月均注射10μg重组乙型肝炎疫苗,48名同时注射免疫球蛋白。50名婴儿中,乙肝母婴传播阻断成功49名,成功率98.0%。阻断失败1名为男婴,其母孕期未采取乙肝阻断措施,婴儿出生后采取人工喂养,按流程接受乙肝疫苗和乙肝免疫球蛋白(HBIG)联合接种,7月龄时采血检测显示阻断失败。结论 HBsAg阳性母亲所生的婴儿出生后联合接种乙肝疫苗和乙肝免疫球蛋白(HBIG)可有效地阻断乙肝的母婴传播。应大力开展乙肝阻断知识的宣传,在孕期和分娩后及时采取母婴阻断干预和随访管理,降低乙肝母婴传播。
Objective To understand the effect of blocking maternal and infant hepatitis B (HBV) in 50 Tuanjiehu communities in Chaoyang District of Beijing from 2006 to 2012. Methods Fifty infants born from 49 hepatitis B virus surface antigen (HBsAg) positive mothers (1 in twins) from 2006 to 2012 were selected for vaccination and follow - up management in the health department of Tuanjiehu Community Health Service Center, Chaoyang District, Beijing. As a survey object. Collect and sort out the basic information of the surveyed subjects, mothers and infants receiving maternal and child blockage, hepatitis B virus infection and postpartum follow-up. Using SPSS16.0 statistical software for data description analysis. Results Of 49 HBsAg positive mothers, only 46 were positive for HBsAg, 2 were positive for both HBsAg and HBeAg, and 1 was positive for HBsAg, DNA and ALT. 44 were from 20 to 34 years old, accounting for 89.8%; 29 were college graduates and above, accounting for 59.2%. Four HBsAg-positive mothers were hepatitis B immunoglobulin during pregnancy with 4 hepatitis B blockers (2 HBsAg positive, 1 HBsAg HBeAg positive, 1 HBsAg positive, DNA ALT positive). The remaining 45 were not involved in the prevention of hepatitis B during pregnancy interruption (hepatitis B immune globulin during pregnancy). Fifty infants were injected with 10μg recombinant hepatitis B vaccine at one and six months after birth, and 48 rabbits simultaneously with immunoglobulin. Among 50 infants, 49 were successfully blocked from mother-to-child transmission of hepatitis B with a success rate of 98.0%. Blockage of a failure of a boy, her mother did not take hepatitis B blockage during pregnancy, the baby after taking artificial feeding, according to the process of hepatitis B vaccine and hepatitis B immunoglobulin (HBIG) combination, 7-month-old blood test showed resistance Fail. Conclusion Infants born to HBsAg-positive mothers combined with hepatitis B vaccine and hepatitis B immunoglobulin (HBIG) after birth can effectively block mother-to-child transmission of hepatitis B. Hepatitis B blockade should be vigorously advocated, in pregnancy and childbirth promptly take maternal and child block intervention and follow-up management, reduce the mother to child transmission of hepatitis B.