CAJ | 학술논문

目的探讨10 μg和20 μg乙肝疫苗与HBIG联合免疫阻断HBV母婴传播的效果.方法 124例HBsAg阳性孕妇所生的婴儿随机分为两组,即10 μg乙肝疫苗组和20 μg乙肝疫苗组.婴儿于出生6h内及30 d分别注射200 IU HBIG,同时分别于出生24 h内、1个月及6个月注射3次10 μg或20 μg重组酵母乙肝疫苗.检测婴儿出生时以及1岁时血清HBV标志物.结果两组新生儿血清HBsAg、HBeAg及抗-HBe阳性率与滴度之间差别均无统计学意义(P＞0.05).所有新生儿血清HBV DNA水平均小于检测下限(500 U/ml).出生12个月时,所有124例婴儿血清HBsAg和HBeAg检测结果均为阴性;血清HBV DNA水平均在检测下限以下;10 μg和20 μg乙肝疫苗组血清抗-HBs阳性率分别为90.3％和96.8％,差异无统计学意义(P＞0.05);抗-HBs水平分别为325.5±342.2 mIU/ml和463.7±353.3 mIU/ml,后者显著高于前者(P=0.01).而且,20 μg乙肝疫苗组产生高应答抗-HBs(＞ 100 mIU/ml)的比例显著高于10μg乙肝疫苗组(P =0.035).结论 20 μg乙肝疫苗联合HBIG方案阻断HBV母婴传播的效果优于10 μg乙肝疫苗联合HBIG方案.
목적 탐토10 μg화20 μg을간역묘여HBIG연합면역조단HBV모영전파적효과.방법 124례HBsAg양성잉부소생적영인수궤분위량조,즉10 μg을간역묘조화20 μg을간역묘조.영인우출생6h내급30 d분별주사200 IU HBIG,동시분별우출생24 h내、1개월급6개월주사3차10 μg혹20 μg중조효모을간역묘.검측영인출생시이급1세시혈청HBV표지물.결과 량조신생인혈청HBsAg、HBeAg급항-HBe양성솔여적도지간차별균무통계학의의(P＞0.05).소유신생인혈청HBV DNA수평균소우검측하한(500 U/ml).출생12개월시,소유124례영인혈청HBsAg화HBeAg검측결과균위음성;혈청HBV DNA수평균재검측하한이하;10 μg화20 μg을간역묘조혈청항-HBs양성솔분별위90.3％화96.8％,차이무통계학의의(P＞0.05);항-HBs수평분별위325.5±342.2 mIU/ml화463.7±353.3 mIU/ml,후자현저고우전자(P=0.01).이차,20 μg을간역묘조산생고응답항-HBs(＞ 100 mIU/ml)적비례현저고우10μg을간역묘조(P =0.035).결론 20 μg을간역묘연합HBIG방안조단HBV모영전파적효과우우10 μg을간역묘연합HBIG방안.
Objective To evaluate the protective effect of 10 μg and 20 μg hepatitis B vaccines combined with hepatitis B immune globulin (HBIG) in preventing mother-to-infant transmission of HBV.Methods One hundred and twenty-four infants whose mothers were HBsAg positive were randomly divided into two groups,i.e.10 μg and 20 μg hepatitis B vaccine group.Hepatitis B vaccine at 10 μg or 20 μg dose was inoculated on 0,1,6 month schedule with administration of 200IU HBIG at birth and 1 month.Serum HBV markers of the infants were detected at birth and 12 month.Results At birth,the positive rates and levels of serum HBsAg,HBeAg and anti-HBe in 124 infants between the two groups had no significant difference(P ＞0.05),serum HBV DNA was not detected.At 12 month,serum HBsAg,HBeAg and HBV DNA in 124 infants were negative; the positive rate of anti-HBs was 90.3％ and 96.8％ (P ＞ 0.05) ; the level of anti-HBs was 325.5 ± 342.2 mIU/ml and 463.7 ± 353.3 mIU/ml(P =0.01) in 10 μg and 20 μg hepatitis B vaccine group,respectively.The rate of more than 100 mIU/ml anti-HBs in 20 μg hepatitis B vaccine group was significantly higher than that in 10 μg hepatitis B vaccine group(P =0.035).Conclusion Administration of 20 μg hepatitis B vaccine combined HBIG has better effect on preventing mother-to-infant transmission of HBV than that of 10 μg hepatitis B vaccine combined HBIG.