论文部分内容阅读
目的探讨感染HBV孕妇血清HBeAg状况对乙肝疫苗与乙型肝炎免疫球蛋白(HBIG)联合免疫阻断HBV母婴传播效果的影响。方法 51例感染HBV孕妇及其所生的51例婴儿,按照分娩时孕妇血清HBeAg状况分为两组,即HBeAg阳性组与阴性组。所有婴儿于出生6 h内及30 d分别注射200 IU HBIG,同时分别于出生24 h内、生后1个月及生后6个月注射3次20μg的重组酵母乙肝疫苗。检测孕妇分娩时和婴儿出生时以及1岁时静脉血HBV标志物和HBV DNA含量。结果 HBeAg阳性组孕妇血清HBV DNA阳性率和含量均高于阴性组(P=0.000)。51例新生儿血清HBV DNA水平均小于检测下限(1 000拷贝/ml);HBsAg阳性率为7.8%(4/51),两组新生儿HBsAg阳性率和滴度差异无统计学意义(P﹥0.05);孕妇血清HBeAg阳性组新生儿血清HBeAg阳性率及滴度均高于阴性组,而血清抗-HBe阳性率及滴度均低于阴性组(P=0.000)。出生12个月时,所有51例婴儿血清HBsAg和HBeAg检测结果均为阴性,血清HBV DNA水平均在检测下限以下。HBeAg阴性组和阳性组婴儿血清抗-HBs阳性率分别为100.0%(25/25)和96.2%(25/26)(P﹥0.05),HBeAg阴性组婴儿血清抗-HBs水平高于阳性组(P=0.042)。结论孕妇分娩时血清HBeAg状态对乙肝母婴阻断成功率没有影响,但是对婴儿体内保护性抗体的产生有一定影响。
Objective To investigate the effect of serum HBeAg status in pregnant women with HBV infection on the transmission of hepatitis B virus (HBV) and hepatitis B immunoglobulin (HBIG) combined immunization. Methods Fifty-one pregnant women with HBV infection and 51 infants born from them were divided into two groups according to their serum HBeAg status at delivery: HBeAg positive group and negative group. All infants were injected intraperitoneally with 200 IU of HBIG within 6 hours and 30 days of birth. At the same time, 20 μg of recombinant yeast Hepatitis B vaccine was injected three times within one and a half months after birth and three months after birth respectively. Venous blood HBV markers and HBV DNA levels were measured at delivery and at birth and at 1 year of age in pregnant women. Results The positive rate and the content of HBV DNA in pregnant women with HBeAg positive group were higher than those in the negative group (P = 0.000). The serum HBVDNA levels in 51 neonates were all less than the lower limit of detection (1 000 copies / ml), and the positive rate of HBsAg was 7.8% (4/51). There was no significant difference in HBsAg positive rate and titers between the two groups (P> 0.05). The positive rate and the titer of serum HBeAg in serum of HBeAg positive group were higher than that of negative group, while the positive rate and titer of anti-HBe in serum were lower than those in negative group (P = 0.000). At 12 months of birth, all 51 infants had negative serum HBsAg and HBeAg results and serum HBV DNA levels below the lower limit of detection. The positive rates of serum anti-HBs in HBeAg negative group and positive group were 100.0% (25/25) and 96.2% (25/26) respectively (P> 0.05), and the levels of serum anti-HBs in HBeAg negative group were higher than those in positive group P = 0.042). Conclusion The serum HBeAg status of pregnant women during childbirth has no effect on the success rate of hepatitis B virus block, but it has some impact on the production of protective antibodies in infants.