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目的:应用乙肝疫苗和乙肝特异性免疫球蛋白(简称乙肝特免)阻断乙肝母婴传播,比较不同方法阻断效果,探索较好的乙肝母婴阻断方式。方法:本研究采取流行病学实验方法。在孕妇中筛选乙肝病毒感染者,将乙肝病毒感染母亲所生婴儿随机分组,一组(A组)在婴儿出生后使用乙肝疫苗和乙肝特免,另一组(B组)婴儿出生后只使用乙肝疫苗,不使用乙肝特免。两组婴儿出生后都按照国家免疫程序接种乙肝疫苗。两组婴儿在l岁和2岁时分别检测乙肝相关标志物,判定乙肝病毒感染情况。在3岁时采集2岁HBsAg阳性者的血清进一步做乙肝标志物和HBVDNA监测。结果:128名婴儿完成了实验,1岁时检测HBsAg和HBsAb,阳性率分别为24.2%和97.66%,2岁阳性率分别为53%和97.66%,3岁时确定了4例乙肝病毒感染者,其中,A组(接种疫苗加乙肝特免组)l例,感染率为l,75%(1/57),B组(单纯接种疫苗者感染)3例,感染率为4.23%(3/71)。A组感染率低于B组。保护率为58.48%,绝对危险度降低25%。结论:乙肝特免和乙肝疫苗联合使用能提高乙肝母婴传播的阻断率。
OBJECTIVE: To block the transmission of hepatitis B virus (HBV) by using hepatitis B vaccine and hepatitis B immunoglobulin (abbreviated as hepatitis B), and to compare the blocking effect of different methods and to explore the better way of blocking the mother-infant hepatitis B virus. Methods: The study adopted epidemiological experimental methods. In pregnant women screening for hepatitis B virus infection, hepatitis B virus infection in mothers born infants were randomly divided into groups (group A) after the birth of infants with hepatitis B vaccine and hepatitis B immunotherapy, the other group (group B) infants only after use Hepatitis B vaccine, do not use hepatitis B special exemption. Both groups of infants were vaccinated with hepatitis B vaccine in accordance with the national immunization program. Two groups of infants at age 1 and 2 were detected when hepatitis B related markers to determine the status of hepatitis B virus infection. Serum samples of 2-year-old HBsAg-positive individuals at 3 years of age were further monitored for hepatitis B markers and HBVDNA. Results: 128 infants completed the experiment. The positive rates of HBsAg and HBsAb at 1 year old were 24.2% and 97.66%, respectively. The positive rates of 2 years old were 53% and 97.66% respectively. Four infants with hepatitis B virus were identified at the age of 3 , Among which group A (vaccination plus hepatitis B exempt group) was 1 case, infection rate was 1, 75% (1/57), group B (simple vaccination infection) 3 cases, the infection rate was 4.23% (3 / 71). The infection rate in group A was lower than that in group B. The protection rate is 58.48%, and the absolute risk is reduced by 25%. Conclusion: The combined use of hepatitis B immunization and hepatitis B vaccine can improve the blocking rate of mother-infant hepatitis B transmission.