论文部分内容阅读
目的重点探讨乙型肝炎免疫球蛋白(HBIG)在母婴组和婴儿组应用对阻断乙型肝炎病毒(HBV)母婴传播的效果。方法母婴组从产前3个月,即妊娠28周起每隔4周注射HBIG,HBeAg(-)/HbeAb(+)者注射200IU,HBeAg(+)/HBeAb(-)者注射400IU,直至临产共3次;婴儿出生后24h内(最好在出生后6h内)注射HBIG200IU,2周后再加强1次,剂量200IU;按0、1、6月龄接种乙型肝炎疫苗(HBVac)。婴儿组婴儿出生后即按上述程序注射HBIG和HBVac。结果母婴组与婴儿组虽免疫程序不同,但2组婴儿抗HBs阳转率比较,χ2=0.00049,P>0.05,无差异显著性。初步尝试了1例HBeAg(+)、HBVDNA(PCR)7.9×108copies/ml孕妇,在妊娠第36周至分娩前口服拉米夫定,婴儿出生后按程序接种HBIG和HBVac而阻断成功。结论本文免疫结果表明,母婴组与婴儿组虽免疫程序不同,但2组婴儿抗HBs阳转率差异无显著性(P>0.05)。2组中母亲HBeAg(+)/HBeAb(-)者,HBVDNA(PCR)亦为阳性时,病毒载量≥1.0×107 ̄9copies/ml者,易出现免疫失败。
Objective To investigate the effect of hepatitis B immunoglobulin (HBIG) on the mother-to-child transmission of hepatitis B virus (HBV) in maternal and infant groups. Methods In the mother-infant group, 400IU were injected with 200IU and HBeAg (+) / HBeAb (-) injected HBIG and HBeAg (-) / HbeAb (+) every 4 weeks from the first trimester of pregnancy, A total of 3 abortion; infants within 24h after birth (preferably within 6h after birth) injection of HBIG200IU, 2 weeks after the re-intensified 1, the dose of 200IU; 0,1,6-month-old hepatitis B vaccine (HBVac). Infant infants were injected with HBIG and HBVac following the procedure described above. Results Although the immunization procedure was different between mother-infant group and infants group, the positive rate of anti-HBs in infants in two groups was (χ2 = 0.00049, P> 0.05). There was no significant difference. One HBeAg (+) and HBVDNA (PCR) 7.9 × 108copies / ml pregnant women were initially tried, and oral lamivudine was administered from the 36th week of gestation until delivery. The babies were successfully vaccinated with HBIG and HBVac after the birth. Conclusions The results of immunization in this paper show that although the immunization procedure is different between maternal and infant groups, there is no significant difference in the anti-HBs positive rate between the two groups (P> 0.05). In both groups, the mothers with HBeAg (+) / HBeAb (-) and HBVDNA (PCR) were also positive, and the viral load was more than or equal to 1.0 × 107 ~ 9copies / ml.