CAJ | 학술논문

通过对携带乙肝病毒的孕妇及其所产婴儿联合应用被动免疫和主动免疫的分析，以探讨阻断乙肝病毒宫内感染的有效方法。采用酶联免疫法常规检测2205例孕妇乙肝5项标志物（ HBsAg、HBsAb、HBeAg、HBeAb、HbcAb），对其中自愿检测的76名乙肝阳性孕妇用核酸扩增法检测血清 HBV-DNA；所有感染乙肝病毒的孕妇分别于妊娠28、32、36周肌注乙肝免疫球蛋白（HBIG），分娩时取脐带血检测乙型肝炎5项标志物，并对26例脐血乙肝阳性患者检测其 HBV -DNA。婴儿出生24 h 内及时肌注 HBIG，并按0、1、6的程序接种乙肝疫苗，1年后对26例脐血乙肝阳性的婴儿复查血清乙肝5项标志物。结果为：孕妇乙肝感染率为9．12％；乙肝大三阳、乙肝小三阳和乙肝1、5模式相比较：孕妇血清HBV-DNA及脐血HBsAg的阳性率存在显著性差异（均为P＜0．01），且26例脐血 HBsAg阳性样本的 HBV-DNA也存在显著性差异（均为 P ＜0．01）。有25例 HBsAg转阴并获得了 HBsAb，免疫阻断成功率达96．15％。主动免疫和被动免疫联合应用有助于阻断乙肝病毒宫内感染，提高了婴儿的免疫成功率。
통과대휴대을간병독적잉부급기소산영인연합응용피동면역화주동면역적분석，이탐토조단을간병독궁내감염적유효방법。채용매련면역법상규검측2205례잉부을간5항표지물（ HBsAg、HBsAb、HBeAg、HBeAb、HbcAb），대기중자원검측적76명을간양성잉부용핵산확증법검측혈청 HBV-DNA；소유감염을간병독적잉부분별우임신28、32、36주기주을간면역구단백（HBIG），분면시취제대혈검측을형간염5항표지물，병대26례제혈을간양성환자검측기 HBV -DNA。영인출생24 h 내급시기주 HBIG，병안0、1、6적정서접충을간역묘，1년후대26례제혈을간양성적영인복사혈청을간5항표지물。결과위：잉부을간감염솔위9．12％；을간대삼양、을간소삼양화을간1、5모식상비교：잉부혈청HBV-DNA급제혈HBsAg적양성솔존재현저성차이（균위P＜0．01），차26례제혈 HBsAg양성양본적 HBV-DNA야존재현저성차이（균위 P ＜0．01）。유25례 HBsAg전음병획득료 HBsAb，면역조단성공솔체96．15％。주동면역화피동면역연합응용유조우조단을간병독궁내감염，제고료영인적면역성공솔。
Objective:To investigate the effectiveness of interrupting intrauterine infection of Hepatitis B through the analysis of the combination of active and passive immunotherapy on pregnant women with Hepati-tis B and their new -born infants.Method:2 205 cases of pregnant women were chosen to detect 5 surface markers of HBV ( HBsAg,HBsAb HBeAg,HBeAb,HbcAb) by enzyme-linked immunoassay and 76 volun-teers with Hepatitis B positive were detected HBV -DNA in the serum by using nucleic acid amplification method.All of the pregnant women infected with HBV were injected HBIG respectively in the 28th,32nd and 36th week of their gestation,and when giving birth,the umbilical cord blood was drawn to detect 5 surface markers of HBV.Then HBV -DNA detection was done for the 26 cases with positive HBV surface antigen in umbilical cord blood .All of the neonates were injected HBIG within 24 hours and HB vaccination accord-ing to the 0,1,6 schemes,and the 26 neonates cases with positive HBV surface antigen in umbilical cord blood were reexamined 5 surface markers of HBV after a year .Result:The HBV infection rate of the pregnant women was 9.12%;Comparing among "Hepatitis B Large -three -positive""Hepatitis B Small -three-positive,"Hepatitis B and HBV 1,5 pattern:the result was achieved that for all of the pregnant women in-fected with HBV,the positive rate of HBV -DNA in the serum and HBsAg in umbilical cord blood of posi-tive was significantly different (all P<0.01), for the 26 cases with positive HBV surface antigen in umbili-cal cord blood,the positive rate of HBV -DNA also existed significant differences (all P<0.01).25 HB-sAg positive cases turned to be negative ones and acquired HBsAb .The successful immune -interrupting rate was 96.15%.Conclusion:The combination of active and passive immunotherapy can block the HBV intrau-terine infection and improve the success rate of baby's immunization .