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目的探讨乙型肝炎病毒(hepatitis B virus,HBV)感染孕妇及其新生儿出生时乙肝病毒标志物的表现模式,为HBV母婴传播诊断和防治提供临床依据。方法于分娩前抽取肘静脉血检测1 537例HBV感染孕妇HBV标志物,并于乙肝主-被动免疫前抽取1 550例(双胎13例)新生儿股静脉血检测HBV标志物,对母婴HBV标志物表现模式进行分析。结果 1 537例孕妇有11种HBV标志物模式,“大三阳”(即HBsAg(+)、抗-HBs(-)、HBeAg(+)、抗-HBe(-)、抗-HBc(+))1 035例(67.34%),“小三阳”(即HBsAg(+)、抗-HBs(-)、HBeAg(-)、抗-HBe(+)、抗-HBc(+))389例(25.31%)。新生儿有17种HBV标志物模式,主要有HBsAg(-)、抗-HBs(-)、HBeAg(+)、抗-HBe(-)、抗-HBc(+)744例(48.00%),HBsAg(-)、抗-HBs(-)、HBeAg(-)、抗-HBe(+)、抗-HBc(+)386例(24.90%),“大三阳”188例(12.13%)。结论 HBV感染孕妇的新生儿为HBV感染高危人群,在隔离保护的同时需要进行正规全程的乙肝主-被动联合免疫,防止HBV母婴传播。
Objective To investigate the expression patterns of hepatitis B virus (HBV) markers in pregnant women and their newborns infected with hepatitis B virus (HBV) and provide a clinical basis for the diagnosis and prevention of HBV infection. Methods The HBV markers of 1 537 pregnant women with HBV infection were detected by elbow venous blood before delivery and 1 550 cases (twins of 13) of newborn femoral vein blood samples were drawn before HBV-passive immunization to detect HBV markers. HBV marker performance patterns were analyzed. Results There were 11 patterns of HBV markers in 1 537 pregnant women, including HBsAg (+), anti-HBs (-), HBeAg (+), anti-HBe (-) and anti-HBc (Ie HBsAg (+), anti-HBs (-), HBeAg (-), anti-HBe (+) and anti-HBc (+)) in 1035 cases (67.34% 389 cases (25.31%). There are 17 patterns of HBV markers in neonates, including 744 cases (48.00%) of HBsAg (-), anti-HBs (-), HBeAg (+), anti-HBe (-), anti-HBc (-), anti-HBs (-), HBeAg (-), anti-HBe (+), anti-HBc (+) 386 cases (24.90%) and “Big Sanyang” 188 cases (12.13%). Conclusions The newborns of HBV infected pregnant women are at high risk of HBV infection. In isolation and protection, they need to carry out the full-scale primary and secondary passive immunization of hepatitis B to prevent mother-to-child transmission of HBV.