摘要
目的探讨乙型肝炎高病毒载量孕妇母婴传播实施综合干预的方法及失败的原因、防范措施。方法回顾性分析乙型肝炎高病毒载量孕妇母婴传播实施综合干预失败2例的临床资料。结果1例孕3个月于当地医院建卡时查HBsAg(+)、HBeAg(+)、HBcAb(+),在我院实施综合干预阻断,但新生儿股静脉血、婴儿8个月及3岁时查HBsAg(+)、HBeAg(+)、HBcAg(+),乙型肝炎病毒(HBV)-DNA(1.456~3.258)×10^7 U/ml。1例17岁体检时发现HBsAg(+)、HBeAg(+)、HBcAb(+),孕后在我院实施综合干预阻断,新生儿股静脉血检查HBeAg(+)、HBcAg(+),HBV-DNA(-);婴儿8个月时检查HBV血清学标志物及HBV-DNA均(-);3岁时复查HBsAg(+)、HBeAg(+)、HBcAb(+),HBV-DNA 6.675×10^7 U/ml。结论孕期及产前HBV-DNA高水平及婴幼儿免疫无应答者未加强免疫是乙型肝炎高病毒载量孕妇经综合干预失败的原因,对此类患者需采取针对性措施进行防范。
Objective To explore methods of comprehensive intervention of mother-to-child transmission of high hepatitis B viral load in pregnant women as well as causes of failure and preventive measures.Methods We retrospectively analyzed the clinical data of the two failure cases of comprehensive intervention for transmission from pregnant women with high hepatitis B viral load to the child.Results A pregnant woman with high hepatitis B viral load who had been found HBsAg positive,HBeAg positive and HBcAb positive when establishing data in the local hospital received comprehensive intervention in our hospital.After birth,the infant was detected with HBsAg positive,HBeAg positive,HBcAg positive,and HBV-DNA positive(1.456-3.258)×10^7 U/ml in neonatal venous blood test and during the 8-month and 3-year-old physical examinations.One was detected with HBsAg positive,HBeAg positive and HBcAb positive at the age of 17.She was given comprehensive intervention in our hospital during pregnant period.After the infant was born,we detected HBeAg positive,HBcAg positive and HBV-DNA negative in the neonatal venous blood,while HBV serological markers negative and HBV-DNA negative at 8 months,but HBsAg positive,HBeAg positive,HBcAb positive and HBV-DNA positive 6.675×10^7 U/ml at the age of 3.Conclusion The lack of enhanced immunization in the women with high level of HBV-DNA during pregnancy and prenatal period and non-responders in terms of infant immune response were the causes of failure of comprehensive intervention in pregnant women with high hepatitis B viral load.For these kinds of patients,targeted measures should be taken.
作者
姜树勤
张丽
姜树萍
吴彩花
闫俊锋
王沙沙
肖献花
JIANG Shu-qin;ZHANG Li;JIANG Shu-ping;WU Cai-hua;YAN Jun-feng;WANG Sha-sha;XIAO Xian-hua(Department of Obstetric Infection,Infectious Disease Hospital of Handan City,Handan,Hebei 056001,China;Department of Obstetrics and Gynecology,the Fourth Hospital of Handan City,Handan,Hebei 056200,China;Department of Obstetrics and Gynecology,Maternal and Child Health Care Center of Handan,Handan,Hebei 056001,China)
出处
《临床误诊误治》
2020年第8期1-4,共4页
Clinical Misdiagnosis & Mistherapy
关键词
乙型肝炎
孕妇
母婴传播
综合干预
失败
Hepatitis B
Pregnant women
Mother-to-child transmission
Comprehensive intervention
Failure
