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目的探讨阻断乙型肝炎病毒宫内传播的方法及意义。方法选取番禺区南村医院2010年5月~2012年5月携带乙肝病毒的150例孕妇,将其随机均分为实验组和对照组(n=75),对150例孕妇及产下的健康新生儿152例进行12个月的随访。结果实验组75例新生儿中共有18例随访测出HBsAg(+)和/或HBeAg(+)的婴儿,占新生儿总数的24%;对照组77例新生儿中有54例随访测出HBsAg(+)和/或HBeAg(+)的婴儿,占新生儿总数的70.13%。实验组新生儿宫内感染率为6.67%,显著低于对照组15.58%(P<0.05);实验组慢性肝炎(ALT持续>40IU/L)的发生率为2.67%,显著低于对照组7.79%(P<0.05)。实验组宫内感染儿的HBV-DNA检测阳性率为40%,对照组为50%,2组比较差异无统计学意义。结论产前做好乙肝预防工作,通过给予孕妇多次肌内注射免疫球蛋白可以有效地阻断乙型肝炎病毒的宫内感染,且随访未发现明显的不良反应,因此可以应用于临床。
Objective To explore the method of blocking intrauterine transmission of hepatitis B virus and its significance. Methods 150 pregnant women with hepatitis B virus from May 2010 to May 2012 in Panyu District Nancun Hospital were randomly divided into experimental group and control group (n = 75), 150 pregnant women and healthy newborn 152 cases were followed up for 12 months. Results A total of 18 infants of 75 newborns in the experimental group were followed up for 24% of the newborns with HBsAg (+) and / or HBeAg (+), and 54 of 77 newborns in the control group were followed up for HBsAg (+) And / or HBeAg (+) infants, accounting for 70.13% of the total number of newborns. The intrauterine infection rate in experimental group was 6.67%, which was significantly lower than that in control group (15.58%, P <0.05). The incidence of chronic hepatitis (ALT lasting> 40IU / L) in experimental group was 2.67%, which was significantly lower than that in control group % (P <0.05). In the experimental group, the positive rate of HBV-DNA in intrauterine infection was 40% in the control group and 50% in the control group. There was no significant difference between the two groups. Conclusion Prenatal hepatitis B prevention work, by giving pregnant women multiple intramuscular immunoglobulin intrauterine infection can effectively block the hepatitis B virus, and no significant adverse reactions were followed up, so it can be used in clinical practice.