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[目的]研究运用不同方法注射乙肝免疫球蛋白阻断乙型肝炎病毒(HBV)母婴垂直传播的效果。[方法]200例乙肝标志物(HBVM)阳性孕妇,其中乙肝病毒DNA(HBV-DNA)阳性孕妇100例,随机分为A组50例,B组50例;乙型肝炎病毒(HBV)携带者孕妇100例(HBV-DNA阴性),随机分为C组50例,D组50例。A组、C组孕妇于孕36周注射HBIG(乙肝免疫球蛋白)200IU;B组、D组孕妇不注射HBIG。200例均于36周和分娩后抽静脉血作HBVM定性、HBV-DNA定量检测。新生儿根据孕妇组别分为A1、B1、C1、D1组。4组均于出生6h(h)内和1月龄分别注射HBIG100IU;出生12h内、1月龄、6月龄分别接种乙肝疫苗(HBVac)10μg。采集新生儿脐血和6月龄静脉血作HBV定性和HBV-DNA定量检测。[结果]①A组、B组孕妇接种前后血清HBV-DNA平均滴度比较,差异无统计学意义(P﹥0.05);A组、B组、C组、D组相互间接种前后HBV-DNA平均滴度比较,差异无统计学意义(P﹥0.05)。②B1组与C1组HBsAg-DNA阳性率比较差异有统计学意义(P﹤0.05),其余各组间比较无差异。③6月龄HBV感染率A1组、B1组、C1组、D1组分别8.0%、10.0%、6.0%、6.0%,4组相互间比较母婴传播阻断率差异无统计学意义(P﹥0.05)。[结论]对HBV-DNA阳性、HBV携带者孕妇孕晚期无论注射HBIG与否,并不影响其新生儿出生时应用HBIG和HBVac联合免疫阻断HBV母婴垂直传播的效果。
[Objective] To study the effect of using different methods of injection of hepatitis B immunoglobulin to block the vertical transmission of hepatitis B virus (HBV) between mother and infant. [Method] 200 pregnant women with positive HBVM were divided into 100 pregnant women with HBV-DNA positive and 50 pregnant women randomly in group A and 50 in group B. HBV carriers 100 pregnant women (HBV-DNA negative) were randomly divided into group C 50 cases, group D 50 cases. Group A, Group C pregnant women injected with HBIG (hepatitis B immunoglobulin) 200IU 36 weeks of pregnancy; Group B, D pregnant women do not inject HBIG. 200 cases were in 36 weeks and after delivery venous blood for qualitative HBVM, HBV-DNA quantitative detection. Neonates were divided into groups A1, B1, C1 and D1 according to the group of pregnant women. 4 groups were injected with HBIG100IU within 6h (1h) and 1 month of age respectively, and 10μg hepatitis B vaccine (HBVac) were given within 1h and 6 months after birth. Neonatal cord blood and 6-month-old venous blood were collected for qualitative analysis of HBV and quantitative detection of HBV-DNA. [Results] ① The average serum HBV-DNA titer before and after inoculation of pregnant women in group A and group B had no significant difference (P> 0.05). The average HBV-DNA levels of group A, group B, group C and group D before and after inoculation Titers, the difference was not statistically significant (P> 0.05). ② The positive rates of HBsAg-DNA in group B1 and group C1 were significantly different (P <0.05), and there was no difference in other groups. (3) HBV infection rate of 6 months old in group A1, group B1, group C1 and group D1 were 8.0%, 10.0%, 6.0%, 6.0%, respectively. There was no significant difference in the rate of HBV transmission between the four groups ). [Conclusion] Whether HBV-DNA positive pregnant women with HBV carriers in late pregnancy regardless of the injection of HBIG or not does not affect the neonatal birth HBIG and HBVac combined immunization block HBV vertical transmission of mother and child.