CAJ | 학술논문

目的：通过观察乙肝免疫球蛋白（HBIG）联合拉米夫定（LM）对孕妇乙型肝炎表面抗原（HBsAg）、乙型肝炎e抗原（HBeAg）表达及乙型肝炎病毒-DNA（HBV-DNA）载量的影响，探讨HBIG联合LM对乙肝母婴阻断的效果。方法选取150例HBsAg及HBeAg双阳性且HBV-DNA＞0．5×107copy／mL孕妇，按前瞻随机开放法均分为2组，各75例。Ⅰ组孕妇给予HBIG＋LM治疗，Ⅱ组单用HBIG治疗。结果两组孕妇孕28周、孕36周及分娩前丙氨酸氨基转移酶（ALT）水平变化不大（P＞0．05）；治疗后两组HBsAg及HBeAg均有不同程度的转阴，但差异无统计学意义（P＞0．05）；Ⅰ组孕妇孕28周至分娩前HBV-DNA载量下降值最大（P＜0．01），宫内HBV感染率为8．0％，明显低于Ⅱ组（P＜0．05）。结论 HBIG联合LM可有效降低孕妇HBV-DNA载量，降低新生儿HBV感染率。
목적：통과관찰을간면역구단백（HBIG）연합랍미부정（LM）대잉부을형간염표면항원（HBsAg）、을형간염e항원（HBeAg）표체급을형간염병독-DNA（HBV-DNA）재량적영향，탐토HBIG연합LM대을간모영조단적효과。방법선취150례HBsAg급HBeAg쌍양성차HBV-DNA＞0．5×107copy／mL잉부，안전첨수궤개방법균분위2조，각75례。Ⅰ조잉부급여HBIG＋LM치료，Ⅱ조단용HBIG치료。결과량조잉부잉28주、잉36주급분면전병안산안기전이매（ALT）수평변화불대（P＞0．05）；치료후량조HBsAg급HBeAg균유불동정도적전음，단차이무통계학의의（P＞0．05）；Ⅰ조잉부잉28주지분면전HBV-DNA재량하강치최대（P＜0．01），궁내HBV감염솔위8．0％，명현저우Ⅱ조（P＜0．05）。결론 HBIG연합LM가유효강저잉부HBV-DNA재량，강저신생인HBV감염솔。
Objective To investigate the impact of hepatitis B immune globulin (HBIG)combined with lamivudine (LM)in treating pregnant women with hepatitis B surface antigen (HBsAg ),hepatitis B e antigen (HBeAg )expression and HBV-DNA (HBV-DNA ) load,and to explore the efficacy of LM combined with HBIG on interrupting hepatitis B virus mother-to-child transmission.Methods 150 cases of HBsAg,HBeAg-positive and HBV-DNA >0.5 ×107copy/mL pregnant woman were divided into 2 groups on a prospec-tive randomized open method,75 cases in each group.Treatment group Ⅰ was given HBIG+LM,the treatment group Ⅱ used HBIG.Results After treatment,the ALT of the two groups in 28,36 weeks of pregnancy had no significant difference (P >0.05 );the HBsAg and HBeAg of the two groups had different levels of negative,but the difference was not statistically significant (P >0.05 ). Treatment groupⅠHBV-DNA load reducted maximum value (P <0.01 ),the intrauterine HBV infection rate was 8.0%,which was significantly lower than the treatment group Ⅱ(P <0.05 ).Conclusion HBIG combined with LM can effectively reduce pregnant wom-en′s HBV-DNA load,and reduce neonatal HBV infection rate.