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[目的]综合评价孕晚期注射乙肝免疫球蛋白联合新生儿注射乙肝免疫球蛋白及乙肝病毒疫苗阻断乙肝病毒母婴传播的有效性,为制定重点人群的乙肝免疫策略提供循证依据。[方法]应用计算机检索相关文献,实验组干预措施为孕晚期注射乙肝免疫球蛋白,新生儿注射乙肝免疫球蛋白和乙肝病毒疫苗;对照组干预措施仅为新生儿注射乙肝病毒疫苗。对符合纳入标准的8项随机对照研究,采用固定和随机效应模型进行Meta分析。[结果]各纳入文献的发表偏倚较小。Meta分析显示实验组母婴传播率(6.01%)低于对照组(16.37%),χ2=7.02,P<0.001;合并RR为0.37,95%可信区间为0.28~0.48,敏感性分析提示模型稳定性较好。亚组分析显示无论对于单纯HBsAg阳性还是HBsAg和HBeAg双阳性的孕妇;或者不管是以新生儿出生24h内乙肝感染标志阳性或是以出生后12个月乙肝感染标志阳性为标准,实验组的母婴传播率均低于对照组(P<0.05)。[结论]孕晚期注射乙肝免疫球蛋白联合新生儿注射乙肝免疫球蛋白及乙肝病毒疫苗能有效地阻断乙肝病毒的母婴传播。
[Objective] To comprehensively evaluate the effectiveness of injecting hepatitis B immunoglobulin combined with neonatal injection of hepatitis B immunoglobulin and hepatitis B virus in the third trimester of pregnancy to block the mother-to-child transmission of hepatitis B virus and provide an evidence base for formulating the hepatitis B immunization strategy for key populations. [Methods] The related literatures were retrieved by computer. Intervention in experimental group was hepatitis B immunoglobulin in the third trimester of pregnancy. Hepatitis B immunoglobulin and hepatitis B virus were injected into neonates. The control group only received hepatitis B virus vaccine. Eight randomized controlled studies that met the inclusion criteria were analyzed for meta-analysis using both fixed and random effects models. [Results] The publication publication bias of each inclusion was small. Meta-analysis showed that the rate of mother-to-infant transmission in the experimental group (6.01%) was lower than that in the control group (16.37%), χ2 = 7.02, P <0.001; the combined RR was 0.37 and the 95% confidence interval was 0.28-0.48. Stability is better. Subgroup analysis showed that both HBsAg positive and HBsAg positive HBeAg positive pregnant women; or whether it is within 24 hours after birth of newborns infected with hepatitis B infection was positive or positive markers of hepatitis B infection 12 months after birth as the standard mother of the experimental group Infant transmission rates were lower than the control group (P <0.05). [Conclusion] The injection of hepatitis B immunoglobulin combined with neonatal injection of hepatitis B immunoglobulin and hepatitis B virus vaccine during the third trimester of pregnancy can effectively block the transmission of hepatitis B virus from mother to infant.