摘要
目的探讨可能导致HBsAg阳性产妇分娩的婴儿乙肝免疫接种后免疫低和无应答的因素。方法回顾性分析2013-2014年在首都医科大学附属北京佑安医院收治的HBsAg阳性产妇分娩的832例新生儿的临床资料,新生儿出生后6 h内及21 d接种乙型肝炎免疫球蛋白200 IU,出生当天和出生后1、6个月注射乙型肝炎疫苗10μg。出生后6 h内、7月龄抽取股静脉血,检查HBV标志物和HBV DNA定量。按照产妇孕期是否接受抗病毒治疗、母乳喂养、父亲HBsAg情况、母亲HBeAg情况分组,评估上述因素对婴儿乙肝免疫接种应答情况的影响。结果产妇孕期接受抗病毒治疗组的婴儿低和无应答率为8.6%（25/290）,未行抗病毒治疗组的婴儿低和无应答率为7.0%（38/542）,差异无统计学意义（χ2=0.60,P=0.44）。母乳喂养组婴儿的低和无应答率为8.8%（18/204）,人工喂养组低和无应答率为7.2%（45/628）,差异无统计学意义（χ2=0.52,P=0.47）。父亲HBsA g阳性组的婴儿低和无应答率为20.0%（5/25）,父亲HBsAg阴性组的婴儿低和无应答率为27.2%（58/807）,差异无统计学意义（χ2=3.00,P=0.08）。母亲HBeAg阳性组的婴儿低和无应答率为9.9%（33/335）,母亲HBeAg阴性的婴儿低和无应答率为6.0%（30/497）,差异无统计学意义（χ2=3.55,P=0.06）。结论 HBsAg阳性产妇分娩的婴儿中,母亲孕期采用抗病毒治疗、母乳喂养、父亲HBsAg阳性和母亲HBeAg阳性对婴儿乙肝免疫应答无明显影响。
Objective To investigate the factors that affect the immune response to hepatitis B vaccine in infants of HBs Ag-positive pregnant women.Methods A total of 832 infants of HBs Ag-positive pregnant women were enrolled into the study. All of the neonates received active-passive immunization therapy with hepatitis B immunoglobulin（HBIG） 200 IU and HBVac 10 μg intramuscular 0,1,6 month after birth. HBV markers and HBV DNA were detected at 7 months＇ follow-up. Results There was no significant difference in the 4 conditions： No and low level immune response rate was 8.6%（25/290） in the infants whose mothers received anti-virus treatment during pregnancy, 7.0%（38/542） in the infants whose mothers didn＇t receive anti-virus treatment（P=0.44）. No and low level immune response rate was 8.8%（18/204） in the infants who received breast-feeding, 7.2%（45/628） in the infants who received artificial feeding（P=0.47）. No and low level immune response rate was 20.0%（5/25） in the infants whose father was HBs Ag positive, 7.2%（58/807） in the infants of HBs Ag-negative fathers（P=0.08）. No and low level immune response rate was 9.9%（33/335） in the infants whose mothers were HBeAg positive, 6.0%（30/497） in the infants whose mothers were HBeAg negative（P=0.06）. Conclusion No and low level immune response in the infants is not associated with whether the mother has received antiviral therapy, the feeding patterns,fathers＇ HBs Ag marker status and mothers＇ HBeAg marker status.
作者
王明
边茜
朱云霞
Wang Ming Bian Qian Zhu Yunxia.(Department of Gynecology and Obsterics,Beijing You＇an Hospital, Capital Medical University, Beijing 100069, China)
出处
《北京医学》
CAS
2016年第12期1279-1281,共3页
Beijing Medical Journal
关键词
婴儿
乙型肝炎病毒
乙型肝炎疫苗
乙肝免疫球蛋白
免疫应答
infant
hepatitis B virus（HBV）
hepatitis B vaccine
hepatis B immunoglobulin（HBIG）
immune response
