云南HBsAg阳性孕产妇生产婴儿免疫应答及感染状况分析

发布时间：2018-06-14 11:35

  本文选题：乙肝病毒 + 母婴阻断　； 参考：《中国公共卫生》2017年12期

【摘要】：目的了解云南省乙肝表面抗原(HBsAg)阳性孕产妇所生婴儿在实施母婴阻断后的免疫应答及乙肝感染状况。方法筛查出全云南省2011年1—6月入院分娩的HBsAg阳性孕产妇,实施母婴阻断后以其所生婴儿为调查对象,于7—12月龄采集静脉血2 mL,分离出血清标本先统一采用ELISA法做乙肝血清学5项指标检测,筛选出HBsAg阳性的标本采用荧光定量PCR法进行乙肝病毒载量(HBV DNA)检测,筛选出HBsAg阴性且乙肝表面抗体(anti-HBs,抗-HBs)阳性的标本采用化学发光法做抗-HBs定量检测。结果共收集到调查对象3 026人,母婴阻断实施后免疫应答率为92.43%,有效免疫应答率为80.04%;低、无免疫应答者占16.09%;母婴阻断失败率为3.87%。本次调查共检出10种乙肝血清标志物组合模式,检出率最高为模式6,占74.62%:其次为模式5,占14.44%:再次为模式7,占3.70%:模式4占3.37%。母婴阻断失败组中,HBV DAN含量5×10~7IU/mL占45.30%;500~5×10~7IU/mL占39.32%;500 IU/mL占15.38%;HBeAg阳性率为79.49%。产生免疫应答组检出3种血清组合模式,乙肝病毒e抗体(anti-HBe,抗-HBe)阳性率为3.79%,乙肝病毒核心抗体(anti-HBc,抗-HBc)阳性率为23.20%。定量检测抗-HBs,抗体水平1 000 mIU/mL的高免疫应答者占66.93%,抗体水平在100~1 000 mIU/mL的中免疫应答者占19.66%,抗体水平在10~100 mIU/mL的低免疫应答者占13.41%。经统计分析,产生免疫应答抗-HBs的抗体水平高低与婴儿体内是否携带抗-HBe、抗-HBc及性别无关。结论对HBsAg阳性孕产妇所生婴儿实施母婴阻断,并建立健全产后对婴儿追踪机制,对预防和控制婴儿感染乙肝起关键作用。
[Abstract]:Objective to investigate the immune response and hepatitis B infection of infants born to pregnant women with hepatitis B surface antigen (HBsAg) positive in Yunnan province. Methods HBsAg positive pregnant women were screened out from January to June 2011 in Yunnan Province, and their infants were selected as the objects of investigation after maternal and infant block. Venous blood samples were collected from 7 to 12 months of age. Serum samples were collected for HBV serological detection by Elisa, and HBV DNA was detected by fluorescence quantitative PCR (FQ-PCR) in HBsAg positive samples. HBsAg negative and anti-HBs (anti-HBsAg) positive specimens were detected quantitatively by chemiluminescence. Results A total of 3 026 subjects were collected, the immune response rate was 92.43, the effective immune response rate was 80.04, the low immune response rate was 16.09, and the maternal and infant blocking failure rate was 3.87. Ten HBV serum markers combination models were found in this survey. The highest detection rate was mode 6 (74.62%), followed by mode 5 (14.44%), mode 7 again (3.70%) and mode 4 (3.37%). In the failed group, the concentration of HBV DAN was 45.30% (55.30%) and 5005 脳 10 7 / mL (39.32ml / mL). The positive rate of HBeAg was 79.49% (P < 0.05). In the immune response group, the positive rates of anti-HBe3.79 and anti-HBc, anti-HBc were 3.79 and 23.20g, respectively. In quantitative detection of anti-HBs, the proportion of high immune responders was 66.93 with the antibody level of 1 000 mIUs / mL, 19.66 with antibody level of 100 ~ 1 000 mIUs / mL, and 13.41 with low immune response with antibody level of 10 ~ 100 mIU- / mL. According to statistical analysis, the level of anti-HBs produced in immune response was not related to whether the infant carried anti--HBe, anti-HBc and sex. Conclusion the prevention and control of hepatitis B infection in infants with HBsAg positive pregnant women is crucial to the prevention and control of infantile infection by blocking the mother and infant, and establishing and perfecting the tracking mechanism of infants after delivery.
【作者单位】： 云南省疾病预防控制中心免疫规划所;中国疾病预防控制中心病毒病预防控制所肝炎室;
【分类号】：R714.251
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本文编号：2017239