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目的探讨阻断HBV母婴垂直传播的方法。方法对670例HBV感染孕妇及其新生儿来分析HBV宫内感染状况及婴幼儿感染情况。结果母亲HBsAg、HBeAg、HBcAb阳性307例,宫内感染56例,宫内感染率18.24%,1岁后随访104例,2例感染,感染率1.92%;母亲HBsAg、HBeAb、HBcAb阳性及HBsAg、HBcAb阳性共363例,宫内感染7例,宫内感染率1.93%,随访118例,无感染者。宫内感染率存在明显差异(P<0.05)。结论孕妇HBsAg、HBeAg滴度高和血清中HBV-DNA的含量高者是宫内感染的重要因素。孕期是否注射乙型肝炎人免疫球蛋白宫内感染无明显差异。降低孕妇血清中HBV-DNA水平,分娩时避免产伤、保护新生儿皮肤黏膜完整,出生时首次免疫的及时性及主被动联合免疫是减少母婴传播的关键。
Objective To explore the method of blocking the vertical transmission of HBV in mother and infant. Methods 670 cases of HBV infection in pregnant women and their newborns to analyze intrauterine infection in HBV status and infant infection. Results The positive rate of HBsAg, HBeAb and HBcAb in mothers was 307, the intrauterine infection was 56, the intrauterine infection rate was 18.24%, 104 were followed up after 1 year, and the infection rate was 1.92% A total of 363 cases of HBcAb positive, intrauterine infection in 7 cases, intrauterine infection rate of 1.93%, followed up 118 cases, no infection. Intrauterine infection rates were significantly different (P <0.05). Conclusion Pregnant women with high HBsAg and HBeAg titers and high levels of HBV-DNA in serum are important factors of intrauterine infection. There was no significant difference in intrauterine infection of hepatitis B immunoglobulin during pregnancy. Reduce HBV-DNA levels in pregnant women, avoid birth injury during childbirth, protect the integrity of the skin and mucous membranes in newborns, the timeliness of primary immunization at birth and the primary and secondary combined immunization are the key to reduce mother-to-child transmission.