【摘要】 目的　研究乙型肝炎免疫球蛋白 (HBIG)及拉米夫定对HBsAg阳性孕妇的乙肝病毒 (HBV)宫内阻断作用。方法　HBIG组 5 6例 ,孕 2 8w起肌注HBIG 2 0 0U每 4w 1次至分娩 ,拉米夫定组 4 3例 ,孕 2 8w起口服拉米夫定 ,每天 10 0mg至产后 30天。对照组 5 2例 ,未予用药。 3组孕妇均于孕 2 8周、分娩前 ,其新生儿于生后 2 4h内免疫接种前抽静脉血检测HB sAg、HbeAg和HBVDNA定量。结果　HBIG组及拉米夫定组孕妇HBVDNA水平较对照组显著下降 (P <0 .0 5 ) ,其新生儿宫内感染率明显低于对照组 (分别为 16 1% ,16 3%和 32 7% ) ,P <0 .0 5 ,HBIG组与拉米夫定组在HBVDNA变化及新生儿感染率方面无显著性差异 (P >0 .0 5 )。 3组孕妇及其新生儿未发现有不良反应。结论　携带HBV孕妇产前多次注射HBIG或服用拉米夫定均可有效减少HBV宫内感染发生率。更多还原

【Abstract】 Objective: To study the interruption of HBV uteral transmission by HBV specific immunoglobin(HBIG) and Lamivudine in HBsAg positive pregnant women. Methods: Each subject in HBIG group(56 cases) accepted 200 IU HBIG intramuscularly every 4 weeks before delivery since 28th week of gestation. Each subject in Lamivudine group(43 cases) received 100mg Lamivudine every day from the 28th week of gestation to 30 days after labour. The control group (52 cases) were followed up without any specific treatment. Blood specimens were tested for HBsAg,HbeAg and HBV?DNA in all the subjects at the 28th week of gestation and before delivery,and their neonates in 24 hours before the administration of immune prophylaxis. Result: HBV?DNA and the rate of neonatal intrauteral infection in HBIG group and Lamivudine group was lower than the control group significantly(16.1%,16.3% vs 32.7%,P<0.05),but there was no significant difference between HBIG group and Lamivudine group(16.1% vs 16.3%,P>0.05).No side effects were found in the pregnant women and their neonates. Conclusion: HBV intrauterine infection can be interrupted effectedly by using HBIG or Lamivudine before delivery in HBsAg positive pregnant women.更多还原