Effects of the hepatitis B immune globulin on the antenatal interruption of pregnant women infected with hepatitis B virus
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摘要: 目的 对合肥市乙肝感染孕妇母婴阻断结果进行分析,评价现行的产前阻断方式的有效性,为阻断乙肝病毒垂直传播提供依据。方法 利用已经建立的合肥市乙肝感染孕妇监测系统,按照乙肝感染孕妇乙型肝炎病毒-DNA(hepatitis B virus-DNA,HBV-DNA)滴度的风险区和产前是否注射乙肝免疫球蛋白分组,在婴儿一周岁时检测乙肝五项,乙肝表面抗原(hepatitis B surface antigen, HBsAg)阳性者为阻断失败。同时对注射乙肝免疫球蛋白(hepatitis B immune globulin,HBIg)的乙肝感染孕妇进行注射前和注射后HBV-DNA病毒滴度监测,以研究产前注射乙肝免疫球蛋白对乙肝病毒垂直传播的影响。结果 2009-2013年全市共监测乙肝感染孕妇395例,对照组的阳性率为2.74%,阻断组的阳性率为3.88%。χ2检验显示两组间阳性率差异无统计学意义。注射HBIg的乙肝感染孕妇注射前和注射后HBV-DNA病毒滴度变化差异无统计学意义。结论 乙肝感染孕妇产前注射乙肝免疫球蛋白的效果有待进一步研究。Abstract: Objective To analyze the results of the mother-to-infant transmission interrupting of hepatitis B virus (HBV) in Hefei and evaluate the validity of current antenatal interruption method, so as to provide reasonable basis for the interrupting. Methods This study was established on the monitoring system of the pregnant women infected with HBV in Hefei. The pregnant women infected with HBV were grouped according to the risk of HBV-DNA titers and condition of antenatal injection of hepatitis B immune globulin (HBIg). All their infants were investigated five makers of hepatitis B at one year old. And if the hepatitis B surface antigen (HBsAg) was positive, it came that the interrupting failed. The HBV-DNA titers of the pregnant women injected with HBIg were monitored both before and after injection, so as to study the effect of HBIg on the mother-to-infant transmission antenatal interruption. Results The total cases of pregnant women with HBV were 395 from 2009 to 2013. The positive rate of control group was 2.74% and the treatment group was 3.88%. The difference between two rates was not statistically significant by Chi-square test and also the titer change between before and after injection. Conclusions Effect of HBIg on the antenatal interruption of pregnant women infected with HBV should be further studied.
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Key words:
- Hepatitis /
- Pregnant women /
- Comp study
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中华医学会肝病学分会,中华医学会感染病分会. 慢性乙型肝炎防治指南 [J]. 中国临床医生, 2012,40(4):66-78. 罗献伟,王建军. 安徽省2006年1~59岁人群乙型病毒性肝炎感染状况的血清流行病学调查 [J]. 中华疾病控制杂志, 2013,17(2):157-159. 迮文远. 计划免疫学 [M].第2版. 上海:科学技术文献出版社, 2001:1256-1257. 肖小敏,张昭. 妊娠合并乙型肝炎病毒感染 [J]. 中华产科急救电子杂志, 2013,2(2):87-93. 庞丽红,黄海霞,黄星. 妊娠晚期注射乙肝免疫球蛋白对阻断乙肝病毒母婴传播的效果 [J]. 广西医科大学学报, 2013,30(2):199-201. 李兰娟,任红. 传染病学 [M].第8版. 北京:人民卫生出版社, 2013:17-43. 李栋梁,王晓萍,刘振武,等. 1991-2006 年合肥市15 岁以下儿童乙型病毒性肝炎流行病学分析 [J]. 疾病监测, 2008,23 (3):164-166. 张丽霞,刘芳,吴海倩,等. 信息化管理手段预防乙肝母婴传播的效果评价 [J]. 中国妇幼保健, 2015,30(35):6174-6176. 中华医学会妇产科学分会产科学组. 乙型肝炎病毒母婴传播预防临床指南(第1版) [J]. 中华妇产科杂志, 2013,48(2):151-154. 袁荣,王晨虹,刘晓梅,等. HBV母婴传播致新生儿免疫失败的原因和机制 [J]. 第四军医大学学报, 2005,26(7):647-649. Zhu Q, Yu G, Yu H, et al. A randomized control trial on interruption of HBV transmission in uterus [J]. Chin Med J (Engl), 2003,116(5):685-687. 谢新宝,朱启镕. 乙型肝炎病毒母婴传播和阻断的研究进展 [J]. 传染病信息, 2006,19(3):101-102. 董悦. 《慢性乙型肝炎防治指南》中阻断母婴传播的相关内容 [J]. 中华围产医学杂志, 2006,9(5):360. Yuan J, Lin J, Xu A, et al. Antepartum immunoprophylaxis of three doses of hepatitis B immunoglobulin is not effective:a single-centre randomized study [J]. J Viral Hepat, 2006,13(9):597-604. 韩忠厚,钟连华,王佳,等. 妊娠晚期孕妇注射乙型肝炎免疫球蛋白对其血清HBV-DNA及新生儿抗- HBs的影响 [J]. 中华内科杂志, 2007,46(5):376-378. 徐陈瑜,陈洁,温坚,等. 乙型肝炎疫苗和乙肝免疫球蛋白阻断乙肝病毒母传播的效果 [J]. 现代妇产科进展, 2013,22(1):1-5. 周乙华,胡娅莉. 有效预防乙型肝炎病毒母婴感染的策略 [J]. 中华围产医学杂志, 2010,13(4):273-276. Zou H, Chen Y, Duan Z, et a1. Protective effect of hepatitis B vaccine combined with two-dose hepatitis B immunoglobulin on infants born to HBsAg-positive mothers [J]. PLoS One, 2011,6(10):e26748. Chen HL, Lin LH, Hu FC, et a1. Effects of maternal screening and universal immunization to prevent mother-to-infant transmission of HBV [J]. Gastroenterology, 2012,142(2):773-781. 韩国荣,赵伟,余敏敏,等. 乙型肝炎病毒母婴传播不同阻断方法的比较 [J]. 中华妇产科杂志, 2006,41(12):837-838.
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