【摘要】 目的:研究新生儿常规使用乙型肝炎疫苗和乙型肝炎免疫球蛋白(HBIG)预防HBV母婴传播的效果和HBV母婴传播危险因素。方法:纳入HBsAg阳性孕妇的婴儿192例,其中46例生于HBsAg和HBeAg双阳性母亲,详细记录相关因素,随访时采血检测HBV标志。结果:随访幼儿128例,随访率66.7%,随访时幼儿平均年龄(15.8±7.6)月,其中42例出生于HBeAg阳性母亲。共4例(3.1%)HBsAg阳性,同时HBeAg和HBV DNA阳性,均出生于HBeAg阳性母亲;该4例中各有1例因母亲隐瞒病史和新生儿窒息而未使用HBIG,仅2例获得正规免疫预防。56例自然分娩(14例母亲HBeAg阳性)和72例剖宫产(28例母亲HBeAg阳性)幼儿中分别有1例和3例HBsAg阳性(P>0.05),94例(20例母亲HBeAg阳性)母乳喂养和34例人工喂养(22例母亲HBeAg阳性)幼儿中各2例HBsAg阳性(P>0.05)。124例HBsAg阴性幼儿中121例抗-HBs阳性(≥10 mIU/ml),另3例分别为2.55、6.26和6.36 mIU/ml。结论:在日常医疗中,联合运用乙肝疫苗和乙肝免疫球蛋白对预防HBV母婴传播效果良好,母亲HBeAg阳性和预防措施不当是母婴传播的易患因素,分娩方式和喂养方式与HBV母婴传播无关。更多还原

【Abstract】 Objective: To research the effects of neonatal routine applications of hepatitis B vaccine and hepatitis B immunoglobulin( HBIG) in prevention of HBV mother- to- fetus transmission and the risk factors of HBV mother- to- fetus transmission. Methods: A total of 192 infants born by mothers with positive HBsAg were included into the study,including 46 infants born by mothers with positive HBsAg and HBeAg,the relevant factors were recorded detailedly; HBV markers were detected during follow- up. Results: A total of 128 infants were followed up,the follow- up rate was 66. 7%,the average age of infants during follow- up was( 15. 8 ± 7. 6) months,and 42 infants were born by mothers with positive HBeAg. Four infants( 3. 1%) were found with positive HBsAg,HBeAg and HBV DNA,and all of them were born by mothers with positive HBeAg; among the four infants,two infants were not treated with HBIG because of hide of maternal HBV medical history and neonatal asphyxia,respectively,only two infants were treated with normal immunoprophylaxis. Among 56 infants born by spontaneous birth( 14 mothers with positive HBeAg) and 72 infants born by cesarean section( 28 mothers with positive HBeAg),one infant and three infants respectively were found with positive HBsAg( P > 0. 05); among 94 infants fed with breastfeeding( 20 mothers with positive HBeAg) and 34 infants fed with artificial feeding( 22 mothers with positive HBeAg),2 infants and 2 infants respectively were found with positive HBsAg( P > 0. 05). Among 124 infants with negative HBsAg,121 infants were found with positive HBsAb( ≥10 mIU /ml),and the levels of HBsAb in the other three infants were 2. 55,6. 26 and 6. 36 mIU /ml,respectively. Conclusion: In the daily practice,the effect of hepatitis B vaccine combined with HBIG in prevention of HBV mother- to- fetus transmission is good; the risk factors of HBV mother- to- fetus transmission include maternal positive HBeAg and inappropriate preventive measures,delivery modes and feeding ways are not correlated with HBV mother- to- fetus transmission.更多还原