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目的研究母体对胎儿行被动免疫及出生后胎儿行主动免疫在降低乙型肝炎病毒(HBV)宫内感染中的作用。方法选择HBsAg(+)的孕妇共60例,30例孕妇于孕28、32、36周分别肌注高效乙肝免疫球蛋白(HBIG)各200U为试验组;对照组为未注射HBIG的30例HBsAg(+)的孕妇。用ELISA和PCR方法检测母血及脐血、新生儿血中HBV标志物及HBV-DNA。结果试验组31例新生儿中血清抗-HBs(+)29例,对照组5例抗-HBs(+),两者相比有显著差异(P<0.05)。前者新生儿血HBsAg,HBV-DNA检出率明显低于后者。孕妇用药后HBsAg滴度及HBV-DNA水平较用药前明显下降。结论联合免疫能有效降低HBV宫内传播,减少宫内感染的发生。
Objective To investigate the effect of maternal passive immunization of fetus and active immunization of fetus after birth on reducing the intrauterine infection of hepatitis B virus (HBV). Methods A total of 60 pregnant women with HBsAg (+) were selected. 30 pregnant women were intramuscularly injected with 200U of high-activity hepatitis B immunoglobulin (HBIG) respectively at 28, 32 and 36 weeks of pregnancy. The control group was 30 HBsAg- (+) Pregnant women. Serum and cord blood, HBV markers and HBV-DNA in neonates were detected by ELISA and PCR. Results There were 29 cases of anti-HBs (+) in 31 newborn infants and 5 cases of anti-HBs (+) in control group. There was significant difference between the two groups (P <0.05). The former neonatal blood HBsAg, HBV-DNA detection rate was significantly lower than the latter. Pregnant women HBsAg titers and HBV-DNA levels after treatment significantly decreased compared with before treatment. Conclusion Combined immunization can effectively reduce intrauterine HBV transmission and reduce the incidence of intrauterine infection.