目的 了解南昌市两个县区乙肝疫苗(HepB)和乙肝免疫球蛋白(HBIG)阻断乙肝母婴传播效果。方法 对两个县区2016—2019年乙型肝炎表面抗原(HBsAg)阳性母亲所生婴儿实施HepB和HBIG联合免疫,检测血清HBsAg水平,分析HepB和HBIG接种率和免疫后婴儿HBsAg阳性率。结果 HBsAg阳性母亲分娩的2 609名新生儿首针HepB接种率为99.9%,首针HepB及时接种率为99.4%,HBIG接种率和及时接种率分别为100%和98.9%,3剂次HepB全程接种率和全程及时接种率分别为98.6%和30.7%。婴儿HBsAg阳性率为0.54%(14/2 609)。乙肝病毒e抗原(HBeAg)和HBsAg双阳性母亲与仅HBsAg阳性母亲所生婴儿的HBsAg阳性率分别为2.00%和0.10%(χ2校正=27.874,P＜0.001)。结论 HepB和HBIG联合免疫对阻断HBV母婴传播有重要作用。HBsAg和HBeAg双阳性孕妇进行抗病毒治疗,同时应尽量规范接种HepB疫苗。
Abstract
Objective To study the blocking effect of hepatitis B vaccine (HepB) and Hepatitis B immunoglobulin (HBIG) on mother-to-child transmission of hepatitis B virus (HBV) in two counties of Nanchang City. Methods Infants born to hepatitis B surface antigen (HBsAg) positive mothers in two counties from 2016 to 2019 were immunized with HepB and HBIG.The level of serum HBsAg was detected,and the vaccination rate of HepB and HBIG and the HBsAg positive rate of infants after immunization were statistically analyzed. Results Among 2 609 newborns delivered by HBsAg positive mothers,the first dose HepB vaccination rate was 99.9%,the first dose HepB timely vaccination rate was 99.4%,the HBIG vaccination rate and timely vaccination rate were 100% and 98.9% respectively,and the whole dose HepB vaccination rate and whole dose timely vaccination rate were 98.6% and 30.7% respectively.The positive rate of HBsAg in infants was 0.54% (14/2 609).The HBsAg positive rate of infants born to hepatitis B virus e antigen (HBeAg) and HBsAg double positive mothers,and HBsAg positive mothers were 2.00% and 0.10% respectively (χ2 corrected =27.874,P＜0.001). Conclusion Combined immunization with HepB and HBIG plays an important role in blocking mother to child transmission of HBV.Pregnant women with double positive HBsAg and HBeAg should receive antiviral treatment,and HepB vaccine should be vaccinated as standardized as possible.
关键词
乙肝疫苗 /
乙肝免疫球蛋白 /
乙肝表面抗原 /
母婴传播
Key words
Hepatitis B vaccine /
Hepatitis B immunoglobulin /
Hepatitis B surface antigen /
Mother-to-child transmission
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参考文献
[1] 崔富强,庄辉.我国新生儿乙型肝炎母婴阻断成就和展望[J].中国病毒病杂志,2019,9(5): 321-326.
[2] 郭树珍,薛同军.200例新生儿乙肝病毒母婴传播阻断效果及影响因素[J].临床医学研究与实践,2019,4(25): 140-142.
[3] 中华人民共和国国家卫生和计划生育委员会.国家免疫规划疫苗儿童免疫程序及说明(2016年版)[J].中国病毒病杂志,2017,7(2): 81-86.
[4] 刘晓霞,杨安华,王晓琼,等.10μg和5μg乙型肝炎疫苗与乙型肝炎免疫球蛋白联合免疫阻断乙型肝炎病毒母婴传播的效果观察[J].中国疫苗和免疫,2018,24(4): 393-396.
[5] 马丽英,沈利娟.妊娠后期应用替诺福韦治疗血清HBV高载量孕妇阻断HBV母婴传播的疗效及安全性分析[J].实用肝脏病杂志,2019,22(6): 836-839.
[6] 徐玲,陈海明,杜国明.乙肝疫苗和免疫球蛋白阻断乙肝母婴传播效果研究[J].医学动物防制,2017,33(5): 521-522,525.
[7] 温春花.乙肝疫苗联合乙肝免疫球蛋白阻断乙型肝炎病毒母婴传播的临床效果观察[J].中国药物与临床,2019,19(21): 3728-3729.
[8] MAST E E,MARGOLIS H S,FIORE A E,et al.A Comprehensive Immunization Strategy to Eliminate Transmission of Hepatitis B Virus Infection in the United States: Recommendations of the Advisory Committee on Immunization Practices (ACIP) Part 1: Immunization of Infants,Children,and Adolescents[J].Morbidity and Mortality Weekly Report: Recommendations and Reports,2005,54(RR-16).
[9] 国家卫生健康委员会.国家免疫规划疫苗儿童免疫程序及说明(2021年版)[J].中国病毒病杂志,2021,11(4): 1-5.
[10] 彭敬,张定梅,陈加超,等.深圳市宝安区乙肝疫苗联合免疫球蛋白阻断乙肝母婴传播效果观察[J].医学动物防制,2020,36(7): 649-651.
[11] 陆晓莉,常晶晶,穆国霞,等.615例乙肝疫苗联合乙肝免疫球蛋白阻断乙型肝炎母婴传播效果观察[J].宁夏医学杂志,2020,42(9): 820-822.
[12] 眭志祥,袁卫建,郑彬,等.丹阳市乙肝疫苗联合免疫球蛋白母婴阻断效果分析[J].实用预防医学,2017,24(4): 385-387.
[13] 吴淑勤.病毒性乙型肝炎免疫预防[J].医学综述,2008,14(3): 450-452.
[14] 唐小敏,令狐艳,张丽,等.2118例住院分娩孕妇乙型肝炎病毒感染血清标志物及病毒载量分析[J].贵州医科大学学报,2019,44(6): 716-720.
[15] 钟歆,张小勤,朱书力,等.抗病毒治疗对转氨酶异常HBsAg阳性孕妇母婴结局的影响[J].中华医院感染学杂志,2021,31(13): 2050-2054.
[16] 曾健,周丽娜,姜玉.乙肝免疫球蛋白、乙肝疫苗联合替比夫定在乙型肝炎病毒母婴垂直传播中的阻断效果[J].河南医学研究,2020,29(30): 5643-5645.
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