免疫阻断乙型肝炎病毒母婴传播多中心研究

发布时间：2018-01-17 21:25

  本文关键词：免疫阻断乙型肝炎病毒母婴传播多中心研究　出处：《中国实用妇科与产科杂志》2015年01期 　论文类型：期刊论文

  更多相关文章： 乙型肝炎病毒 孕产妇 乙型肝炎免疫球蛋白 母婴传播 免疫阻断

【摘要】：目的探讨孕产妇乙型肝炎表面抗原(HBs Ag)阳性率及乙型肝炎病毒(HBV)母婴传播阻断的效果。方法2008-2012年,通过多中心队列研究,对湖北省、山西省、广东省、新疆维吾尔自治区等地的孕产妇进行HBs Ag筛查;对上述地区部分医院入院分娩的HBs Ag阳性母亲及8~12个月龄婴儿进行随访观察,所有标本检测乙型肝炎血清标志物(HBs Ag,HBs Ab,HBe Ag,HBe Ab,HBc Ab),部分标本检测HBV DNA。结果筛查孕妇82214例,HBs Ag阳性4924例,阳性率6.0%。随访HBs Ag阳性母亲及8~12个月龄婴儿1371对,婴儿免疫阻断失败率3.1%(42/1371),HBs Ag及HBe Ag双阳性母亲婴儿的免疫阻断失败率为8.2%。免疫阻断失败的婴儿其母亲均为HBe Ag阳性且HBV DNA≥6 log10copies/m L。HBe Ag阳性母亲孕期注射乙型肝炎免疫球蛋白(hepatitis B immune globulin,HBIG)及未注射HBIG组,其婴儿免疫阻断失败率差异无统计学意义(8.8%vs.8.1%,P=0.807)。结论多中心调查显示目前孕产妇HBs Ag阳性率6.0%,HBV母婴阻断失败率3.1%。HBs Ag及HBe Ag双阳性且HBV DNA≥6 log10 copies/m L的孕妇应为母婴阻断的重点人群。孕妇孕期注射HBIG不能提高HBV母婴阻断效果。
[Abstract]:Objective to investigate the positive rate of hepatitis B surface antigen (HBs) and the effect of blocking mother-to-child transmission of hepatitis B virus (HBV) in pregnant women. HBs Ag screening was performed on pregnant women in Hubei Province, Shanxi Province, Guangdong Province and Xinjiang Uygur Autonomous region through multicenter cohort study. HBs Ag positive mothers and infants aged from 8 to 12 months were followed up in some hospitals. All samples were tested for HBs Ag in serum. Results 82214 pregnant women were screened for HBs Ag positive for 4 924 cases. The positive rate was 6.0%. 1 371 pairs of infants aged 8 to 12 months were followed up with HBs Ag positive mothers. The failure rate of immune blockade was 3.1% (42 / 1371). The failure rate of HBs Ag and HBe Ag double positive mothers was 8.2%. The mothers of the infants who failed the immune block were both HBe Ag positive and HBV DNA 鈮，

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