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目的观察乙型肝炎(乙肝)疫苗(HBVac)接种次数对阻断高HBV载量母婴传播效果的影响。方法抽取30例HBeAg阳性孕妇足月分娩婴儿(A组,孕妇临产时HBV DNA均>1×106copies/ml)和27例同期条件匹配生产的婴儿(B组)血液标本检查HBVM和HBV DNA定量,予出生时和15d肌肉注射乙肝免疫球蛋白(HBIG)200IU各1针;HBVac 20μg肌肉注射:A组婴儿按0、1、2、6个月方案;B组婴儿按0、1、6个月方案注射。结果随访至7个月龄。免疫程序结束后,A、B两组婴儿抗-HBs滴度、HBeAg值下降速度相仿(P>0.05),但B组有2例婴儿抗-HBs阴性,7例抗-HBs低于100mIU/ml。A、B两组婴儿的ALT和AST差异均无统计学意义(P>0.05)。结论 HBeAg阳性高病毒载量孕妇所生婴儿出生后应用HBIG及HBVac可以获得较好的免疫保护,增加HBVac注射次数可提高婴儿抗-HBs滴度。
Objective To observe the effects of hepatitis B vaccine (HBVac) inoculation on blocking the transmission of HBV from mother to infant. Methods Thirty HBeAg positive pregnant women with full term infants (Group A, HBV DNA> 1 106copies / ml at the time of delivery) and 27 matched infants (Group B) At birth and 15d intramuscular injection of hepatitis B immunoglobulin (HBIG) 200IU each 1 needle; HBVac 20μg intramuscular injection: A group of infants 0,1,2,6 months program; B infants by 0,1,6 months Program injection. The results were followed up to 7 months of age. At the end of the immunization program, the anti-HBs titers and HBeAg values of infants in groups A and B decreased at a similar rate (P> 0.05). However, two infants in group B had anti-HBs negative and seven anti-HBs were less than 100 mIU / ml . There was no significant difference in ALT and AST between A and B infants (P> 0.05). Conclusions HBIG and HBVac can be used to obtain good immune protection in infants born to HBeAg positive high viral load pregnant women. Increasing the number of HBVac injections can increase the titer of anti-HBs in infants.