摘要
目的对新生儿乙型肝炎病毒（hepatitis B virus,HBV）母婴传播的早期干预疗效评价,分析分娩方式及喂养方式对HBV母婴传播的影响。方法选择2013年1月～2015年5月我院携带HBV孕妇所生的796例足月新生儿,出生时检测新生儿血清乙肝表面抗原（HBs Ag）,将HBs Ag阳性的91例新生儿使用随机数字表随机分为治疗组和对照组。所有新生儿在出生12 h内进行肌肉注射乙肝疫苗（hepatitis B vaccine,HBVac）10μg及乙肝免疫球蛋白（hepatitis B immunoglobulin,HBIG）200 U;治疗组新生儿14 d时再次肌肉注射HBIG 200 U,对照组则不再注射HBIG。3个月检测血清乙肝病毒标志物,并进行统计学分析。结果各组婴儿3个月龄时HBV感染率均明显下降;3个月龄时治疗组与对照组HBV感染率差异无统计学意义（P〉0.05）。阴道分娩的新生儿出生时HBV感染率明显高于剖宫产组,差异有统计学意义（P〈0.05）,但3个月龄时HBV感染率差异无统计学意义（P〉0.05）。母乳喂养组与人工喂养组新生儿3个月龄时HBV感染率差异无统计学意义（P〉0.05）。结论携带乙肝病毒的孕妇所生的新生儿,在出生后12 h内肌注HBVac 10μg联合HBIG 200 U可以明显降低HBV感染率;经免疫预防后,阴道分娩的新生儿HBV感染率与剖宫产无明显差异;喂养方式与HBV母婴传播无明显相关性;出生14 d追加肌肉注射HBIG 200 U并不能进一步降低HBV母婴传播率。
Objective To evaluate the early intervention on the mother-to-infant transmission of hepatitis B virus（HBV） in newborns and analysis the effects of different delivery modes and different feeding methods on the mother-toinfant transmission of HBV. Methods Selected 796 pregnant women at term labor who were carrying HBV from January2013 to May 2015, then the neonates born by them who were found with hepatitis B surface antigen（HBs Ag） positive in serum at birth were randomly divided into treatment group and control group. All the neonates were treated with conventional intramuscular injection of hepatitis B vaccine（HBVac） 10 μg and hepatitis B immunoglobulin（HBIG） 200 U in two parts. The neonates in treatment group were treated with intramuscular injection of HBIG 200 U at 14 days after birth,while the neonates in control group didn＇t received HBIG injection. Detected the hepatitis B virus markers in serum three months later. And the results were statistically analyzed. Results The rate of HBV infection was significantly decreased in all infants at three months after birth. And the rate of HBV infection had no significant difference between treatment group and control group（P〉0.05）. The rate of HBV infection in spontaneous delivery group was significantly higher than that in cesarean section group（P〈0.05）. But the rate of HBV infection among three-month infants had no significant difference between two groups（P〉0.05）. The rate of HBV infection had no significant difference be tween breast feeding group and artificial feeding group（P〉0.05）. Conclusion For the neonates who are born by the mothers carrying HBV, injecting HBIG 200 U and HBVac 10 μg in two parts after birth were effective protected from the HBV infection. After immunization, the rate of HBV infection in newborns with spontaneous delivery was not significantly different from that of cesarean section. There is no significant correlation between feeding mode and the motherto-infant transmission of HBV. The method
出处
《中国现代医生》
2016年第3期56-59,共4页
China Modern Doctor
基金
上海市松江区卫生系统科研课题项目(2012-Ⅲ-21)
关键词
乙型肝炎病毒
乙肝免疫球蛋白
母婴传播
早期干预
Hepatitis B virus
Hepatitis B immunoglobulin
Mother-to-infant transmission
Early intervention
