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目的:观察不同母婴阻断方式对HBV阻断效果的影响。方法:2006年1月～2010年1月在承德医学院附属医院进行产前检查的HBV-DNA阳性的孕妇共85例,随机分为3组。其中阻断Ⅰ组30例,只应用HBIG;阻断Ⅱ组30例,孕妇自妊娠28周开始口服拉米夫定,100 mg/天,直至产后30天,新生儿出生后按与阻断Ⅰ组同样的方法注射HBIG;对照组25例,在妊娠末期不采取措施。3组新生儿出生24 h内均注射乙肝疫苗。3组新生儿在出生24 h、7月和12月不同时间分别检测血清HBV-marker和HBV-DNA。结果:阻断I组和II组24 h、7月龄和12月龄HBsAg阳性率低于对照组(P<0.05);阻断I组和II组7月龄和12月龄HbsAb阳性率高于对照组(P<0.05);3组血清HbsAb定量,阻断I组、阻断II组7月龄、12月龄均高于对照组(P<0.05)。结论:孕晚期采用注射HBIG和应用拉米夫定两种不同母婴阻断方式均能够有效阻断HBV母婴传播,降低胎儿的感染率。
Objective: To observe the effect of different blocking methods on HBV blockade. METHODS: From January 2006 to January 2010, 85 pregnant women with HBV-DNA positive prenatal examination at the Affiliated Hospital of Chengde Medical College were randomly divided into three groups. Among them, 30 cases were blocked in group Ⅰ, only HBIG was used; in group Ⅱ, 30 cases were blocked. Pregnant women were given oral lamivudine 100 mg once daily from the 28th week of pregnancy until 30 days postpartum. The same method of group injection of HBIG; control group of 25 patients, do not take measures in the end of pregnancy. Three groups of newborns were vaccinated within 24 h of hepatitis B vaccine. Serum HBV-marker and HBV-DNA were detected in 3 groups of newborns at 24 h, July and December of birth. Results: The positive rates of HBsAg at 24 h, 7 months and 12 months of blocking group I and group II were lower than those of control group (P <0.05). The positive rates of HbsAb in groups I and II at 7 months and 12 months (P <0.05). Serum HbsAb was quantified in 3 groups, group I was blocked, group II was 7 month and 12 month old were higher than the control group (P <0.05). Conclusion: The two different maternal and neonatal methods of injection of HBIG and lamivudine during the third trimester of pregnancy can effectively block the transmission of HBV from mother to infant and reduce the infection rate of the fetus.