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目的观察孕晚期注射HBIG对母乳HBeAg和HBV DNA阳性率的影响。方法87例HBsAg/HBeAg阳性、HBV DNA阳性、肝功能正常的孕妇分为两组。研究组51例,于孕28、32、36周时肌肉注射HBIG,每次200IU;对照组36例,不注射HBIG。所产新生儿均接受主、被动联合免疫即出生后6h内予HBIG200IU肌肉注射,乙肝疫苗以“0、1、6”方案免疫接种,剂量为10μg。比较两组孕妇治疗前后静脉血、母乳、新生儿脐血及婴儿6个月龄外周血HBeAg、HBV DNA阳性率。结果研究组阻断后母血HBV DNA含量(4.10±1.17)低于对照组(5.25±1.30)(P<0.01)。母乳HBV DNA阳性率5.88%,低于对照组的25%(P<0.05)。结论孕晚期HBIG阻断治疗能降低乙肝病毒宫内传播,提高了产妇母乳的安全性。
Objective To observe the effect of HBIG injection on the positive rate of HBeAg and HBV DNA in breast milk in the third trimester of pregnancy. Methods 87 pregnant women with HBsAg / HBeAg positive, HBV DNA positive and normal liver function were divided into two groups. The study group consisted of 51 patients with intramuscular injection of HBIG at 28, 32 and 36 weeks of pregnancy, each with 200 IU; control group, 36 patients without HBIG injection. Neonates were born to accept the main, passive immunization that is 6h after birth intramuscular injection of HBIG200IU, hepatitis B vaccine to “0,1,6 ” program immunization, the dose of 10μg. The positive rates of HBeAg and HBV DNA in venous blood, breast milk, umbilical cord blood of newborn and 6 months old infants were compared before and after treatment. Results The serum HBV DNA level in the study group was 4.10 ± 1.17 less than that in the control group (5.25 ± 1.30) (P <0.01). The positive rate of HBV DNA in breast milk was 5.88%, lower than 25% of the control group (P <0.05). Conclusion The HBIG blockade therapy during the third trimester can reduce the intrauterine transmission of hepatitis B virus and improve the safety of the mother’s breast milk.