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目的 研究乙型肝炎免疫球蛋白 (HBIg)阻断HBsAg阳性孕妇HBV宫内感染的疗效并探讨其适应症。方法 :86例HBsAg阳性孕妇随机分为治疗组 (n =40 )和对照组 (n =46 ) ,均在妊娠 2 8周时抽取静脉血检测HBsAg、HBeAg和HBVDNA。治疗组自 2 8周开始每 4周肌注一次HBIg( 2 0 0IU)直至分娩。对照组不给予上述药物。新生儿出生后即取静脉血检测HBsAg。结果 :治疗组新生儿HBsAg阳性率明显低于对照组。HBeAg阳性和阴性孕妇均可发生宫内感染 ,但HBeAg阳性孕妇所生新生儿HBsAg阳性率明显高于HBeAg阴性者。而两组中HBVDNA阴性孕妇均未发生宫内感染。结论 :HBIg能有效降低HBsAg阳性孕妇的宫内感染发生率 ,HBVDNA检测可以作为是否应用HBIg的指针。
Objective To study the curative effect of hepatitis B immunoglobulin (HBIg) on blocking HBV intrauterine infection in HBsAg-positive pregnant women and to explore its indications. Methods: Totally 86 HBsAg positive pregnant women were randomly divided into treatment group (n = 40) and control group (n = 46). Blood samples were collected for detection of HBsAg, HBeAg and HBVDNA at 28 weeks’ gestation. The treatment group received intramuscular HBIg (200 IU) every 4 weeks from the 28th week until delivery. The control group did not receive the above drugs. After birth, venous blood was taken to detect HBsAg. Results: The positive rate of HBsAg in neonates in the treatment group was significantly lower than that in the control group. Intrauterine infection can occur in HBeAg-positive and -negative pregnant women, but the HBsAg-positive rate of neonates born to HBeAg-positive pregnant women is significantly higher than that of HBeAg-negative. In both groups HBVDNA negative pregnant women did not occur intrauterine infection. Conclusion: HBIg can effectively reduce the incidence of intrauterine infection in HBsAg-positive pregnant women, HBVDNA test can be used as a pointer to HBIg.