目的了解2003-2008年HBsAg阳性孕妇乙肝免疫球蛋白(hepatitis B immunoglobulin,HBIG)注射情况并评价其阻断乙型肝炎病毒(HBV)宫内感染的效果。方法采用问卷调查方式收集HBsAg阳性孕妇孕期HBIG注射史,酶联免疫吸附试验(ELISA)法检测孕妇外周血HBsAg、HBeAg及新生儿出生24h内股静脉血HBsAg,实时荧光定量PCR测定母亲外周血HBVDNA。以新生儿外周血HBsAg阳性判断为宫内感染。结果 2003-2008年孕期HBIG全程注射率从40.4%增长至64.8%,各年全程注射率差异有统计学意义(χ2=22.087,P=0.001);宫内感染率为8.0%~10.0%,各年宫内感染率差异无统计学意义;经χ2检验表明,孕期HBIG注射与宫内感染无关(χ2=0.024,P=0.877)。结论孕期注射HBIG不能阻断HBV宫内感染。
Objective To know the use of hepatitis B immunoglobulin(HBIG) among hepatitis B surface antigen(HBsAg) positive mothers during late pregnancy from 2003 to 2008 and to evaluate the blocking effect of HBIG on mother to infant transmission of hepatitis B virus(HBV).Methods The information on use of HBIG in HBsAg positive mothers was collected with questionnaire.HBeAg and HBsAg was detected with ELISA.HBV DNA in HBsAg positive mothers were detected with RT-PCR.HBV intrauterine infection occurrence was defined if the HBsAg of the newborn was positive.Results The rate of valid HBIG injection during pregnancy were increased from 40.0% to 64.8% in the years and there was a significant yearly difference(χ2 = 22.087,P = 0.001).The rates of HBV intrauterine infection were increased from 8.0% to 10.0% with no significant difference.The administration of HBIG showed no significant effect on HBV intrauterine infection with Chi-square test(χ2 = 0.024,P = 0.877).Conclusion The blocking effect of HBIG administeration on HBV intrauterine transmission is not found.