摘要
目的探讨慢性HBV感染女性所生婴儿HBsAb的分布特征及相关影响因素。方法以605例符合入组要求的慢性HBV感染女性所生婴儿为研究对象,收集母亲既往HBV感染信息、孕期生化指标、孕期并发症、分娩相关信息以及婴儿出生后乙肝相关检测结果,随访调查入组婴儿1岁时HBsAg及HBsAb,同时回顾性收集其在7月龄时HBsAg、HBsAb,通过有序logistic回归分析影响婴儿HBsAb的因素。结果605例婴儿中,有6名婴儿7月龄及1岁时HBsAg及HBV DNA阳性,感染率约为1%。将未感染婴儿根据HBsAb滴度进行分组,结果显示不同组间母亲产前凝血酶原活动度(prothrombin activity,PTA)(χ^(2)=11.17,P=0.01)、HBeAg阳性率(χ^(2)=7.87,P=0.049)以及婴儿出生时HBsAg阳性率(χ^(2)=10.52,P=0.02)存在差异。多元有序Logistic回归分析显示婴儿出生时HBsAg阴性是7月龄时HBsAb独立保护因素(OR=1.564,95%CI 1.092~2.239,P=0.015)。对婴儿1岁时HBsAb进行Logistic回归分析,显示母亲妊娠期糖尿病(OR=1.578,95%CI 1.126~2.210,P=0.008)、婴儿加强免疫(OR=81.207,95%CI 31.202~211.352,P<0.001)、婴儿7月龄抗体量(OR=42.123,95%CI 22.824~77.739,P<0.001)与婴儿1岁时HBsAb独立相关。结论婴儿出生时静脉血HBsAg阴性是其7月龄HBsAb的独立保护因素,加强免疫是1岁时HBsAb的独立保护因素。
Objective To investigate the distribution characteristics and related factors of HBsAb in infants born to women with chronic hepatitis B virus(HBV)infection.Methods A total of 605 infants born to women with chronic HBV infection who met the requirements for inclusion were selected as the subjects.Information about the mother′s previous HBV infection,biochemical indicators during pregnancy,pregnancy complications,information about delivery,and hepatitis B test result after birth were collected.HBsAg and HBsAb at the age of 1 year were determined,and HBsAg and HBsAb at the age of 7 months were retrospectively collected.The factors influencing HBsAb in infants were analyzed by ordered logistic regression.Results In 605 infants,the infection rate was about 1%.Among them,6 infants were positive for HBsAg and HBV DNA at 7 months and 1 year of age.Uninfected infants were divided into groups according to HBsAb titers.The result showed that there were significant differences in prothrombin activity(PTA)(χ^(2)=11.17,P=0.01),positive rate of HBeAg(χ^(2)=7.87,P=0.049)and HBsAg positive rate at birth(χ^(2)=10.52,P=0.02)among different groups.Multivariate ordered Logistic regression analysis showed that HBsAg negative at birth was an independent protective factor for HBsAb at 7 months of age(OR=1.564,95%CI 1.092-2.239,P=0.015).Logistic regression analysis of HBsAb at 1 year of age showed maternal gestational diabetes mellitus(OR=1.578,95%CI 1.126-2.210,P=0.008),infant enhanced immunization(OR=81.207,95%CI 31.202-211.352,P<0.001)and antibody level at 7 months of age(OR=42.123,95%CI 22.824-77.739,P<0.001)were independently associated with HBsAb at 1 year of age.Conclusions HBsAg negative in venous blood at birth was an independent protective factor for HBsAb at 7 months of age,and enhanced immunization was an independent protective factor for HBsAb at 1 year of age.
作者
孙芳芳
毕潇月
王晓娟
曾湛
林妍洁
杨柳
邓雯
蒋婷婷
高媛娇
胡蕾苹
许梦娇
张璐
路遥
李明慧
谢尧
Sun Fangfang;Bi Xiaoyue;Wang Xiaojuan;Zeng Zhan;Lin Yanjie;Yang Liu;Deng Wen;Jiang Tingting;Gao Yuanjiao;Hu Leiping;Xu Mengjiao;Zhang Lu;Lu Yao;Li Minghui;Xie Yao(Division 2,Department of Hepatology,Beijing Ditan Hospital,Capital Medical University,Beijing 100015,China;Department of infectious diseases,Capital Medical University,Beijing 100069,China;Department of Obstetrics and Gynecology,Beijing Ditan Hospital,Capital Medical University,Beijing 100015,China;Division 2,Department of Hepatology,Peking University Ditan Teaching Hospital,Beijing 100015,China)
出处
《中华实验和临床病毒学杂志》
CAS
CSCD
2021年第6期631-638,共8页
Chinese Journal of Experimental and Clinical Virology
基金
北京市医管中心临床专项项目(XMLX 201706、XMLX 202127)
北京市医管中心消化协同中心资助项目(XXZ0302、XXT28)
国家科技重大专项(2017ZX10201201-001-006,2017ZX10201201-002-006,2018ZX10715-005-003-005)
首都临床特色专项资助项目(Z151100004015122)
北京市科委课题(D161100002716002)
首都卫生发展专项公共卫生项目(2021-1G-4061)。
关键词
乙型肝炎病毒
乙肝表面抗体
母婴传播
乙肝疫苗
LOGISTIC回归
Hepatitis B virus
Anti-hepatitis B surface antibody
Mother-to-child transmission
Hepatitis B vaccine
Logistic regression analysis
