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目的研究对HBsAg、HBeAg双阳性母亲及其所生的新生儿采用不同的阻断方法,观察阻断母婴传播的效果有何不同。方法将104名HBsAg,HBeAg双阳性孕妇随机分为两组,对照组(A组)孕妇48名,联合免疫组(B组)孕妇56名。A组孕妇只作常规体检,新生儿只接受乙肝疫苗免疫;B组孕妇于妊娠的28,32,36周各肌注乙肝免疫球蛋白(HBIG)2001U,新生儿应用乙型肝炎疫苗加乙型肝炎免疫球蛋白。两组婴儿均随访1年,满周岁时抽血检测HBsAg和杭一HBs。结果两组的HBsAg阳性率分别为20.41%、7.14%,其中采用乙肝疫苗与乙肝免疫球蛋白联合免疫组HBsAg阳性率显著低于单独采用乙肝疫苗免疫组,两组间有显著性差异【X2=3.99;P<0.05】A组的免疫保护率73.47%,B组的免疫保护率91.07%,两种方案之间有显著性差异[X2=4.53P<0.05]。结论乙肝免疫球蛋白与乙肝疫苗联合免疫对母婴垂直传播的阻断效果优于单独接种乙肝疫苗。
OBJECTIVE: To investigate the different effects of blocking the transmission of mother-to-infant transmission by using different blocking methods for HBsAg and HBeAg-positive mothers and their newborn infants. Methods A total of 104 pregnant women with positive HBsAg and HBeAg were randomly divided into two groups, 48 pregnant women in the control group (A group) and 56 pregnant women in the combined immunization group (B group). A group of pregnant women only for routine physical examination, newborns only received hepatitis B vaccine; pregnant women in group B at 28, 32, 36 weeks of pregnancy intramuscular injection of hepatitis B immunoglobulin (HBIG) 2001U, neonatal hepatitis B vaccine plus B Hepatitis immunoglobulin. Two groups of infants were followed up for 1 year, when the age of blood test for HBsAg and HBsAg. Results The positive rates of HBsAg in both groups were 20.41% and 7.14% respectively. The positive rate of HBsAg in combination group with hepatitis B vaccine and hepatitis B immunoglobulin group was significantly lower than that with hepatitis B vaccine group alone (X2 = 3.99; P <0.05]. The immune protection rate in group A was 73.47%, and that in group B was 91.07%. There was a significant difference between the two protocols [X2 = 4.53P <0.05]. Conclusion The combined immunization with Hepatitis B immunoglobulin and Hepatitis B vaccine has better blocking effect on the vertical transmission of mother-infant than that of hepatitis B vaccine alone.