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[目的]探讨不同免疫阻断方式对HBV母婴传播的阻断作用。[方法]以HBsAg阳性孕妇及其婴儿为对象,按不同阻断方式分组,A组126例采用对孕晚期孕妇及其新生儿注射乙肝免疫球蛋白(HBIG),同时对新生儿联合采用乙肝疫苗注射;B组102例仅新生儿联合使用HBIG及乙肝疫苗注射;C组215例只对新生儿进行乙肝疫苗接种作为对照。检测分析A组孕妇使用HBIG前后血液HBV-DNA含量变化,比较各组新生儿出生后的宫内感染率及1岁后感染率。[结果]A组孕妇使用HBIG前后血液HBV-DNA含量差异无统计学意义,A、B、C3组宫内感染率分别为4.76(6/126)、4.92(5/102)和4.65(10/215),差异无统计学意义,1年后感染率分别为5.92、4.93、8.3,C组HBV感染率与A、B组比较差异有统计学意义(P﹤0.05)。[结论]孕期使用乙肝免疫球蛋白不能降低孕妇病毒载量,对HBV宫内传播也无保护作用。对新生儿联合使用HBIG及乙肝疫苗注射与单纯接种乙肝疫苗相比,能减低HBV感染率。
[Objective] To explore the blocking effect of different ways of immune block on HBV transmission. [Methods] HBsAg-positive pregnant women and their infants were divided into different groups according to different blocking methods. A group of 126 pregnant women and their newborns were injected with HBIG during the third trimester of pregnancy and hepatitis B vaccine In group B, only 102 newborns were injected with HBIG and hepatitis B vaccine; 215 children in group C received hepatitis B vaccination only as a control. The changes of HBV-DNA in blood before and after HBIG in pregnant women in group A were detected and analyzed. The intrauterine infection rate and the infection rate after 1 year of birth were compared between neonates in each group. [Results] There was no significant difference in HBV-DNA levels between before and after HBIG in group A, and the intrauterine infection rates in groups A, B and C3 were 4.76 (6/126), 4.92 (5/102) and 4.65 (10 / 215), the difference was not statistically significant. The infection rates after one year were 5.92, 4.93 and 8.3 respectively. The HBV infection rates in group C were significantly different from those in group A and B (P <0.05). [Conclusion] The use of hepatitis B immunoglobulin during pregnancy can not reduce the viral load of pregnant women and has no protective effect on HBV intrauterine transmission. In newborns combined with HBIG and hepatitis B vaccine compared with simple inoculation of hepatitis B vaccine, can reduce the HBV infection rate.