摘要
目的:探讨乙型肝炎病毒(HBV)感染新生儿单个核细胞(PBMC)的情况及其对高效价乙肝免疫球蛋白(HBIG)及乙肝疫苗阻断垂直传播的影响。方法:选择HBV感染孕妇257例,检测新生儿脐血血清和脐血单个核细胞(UBMC)中的HBV-DNA;所有新生儿出生24h内和生后2周分别注射HBIG200IU,1月时按0、1、6方案注射乙肝疫苗,并在1岁时检测血清HBsAb和HBV-DNA。结果:血清HBV-DNA阳性产妇的新生儿UBMC中24·18%HBV-DNA阳性,低于该组新生儿血清HBV-DNA阳性率(35·29%,P<0·05)。正规注射HBIG和乙肝疫苗后,新生儿脐血清和UBMC中HBV-DNA同时阳性组婴儿1岁时HBsAb阳转率明显低于血清HBV-DNA阳性、UBMC阴性组(50·00%vs·77·78%,P<0·05),二者都低于HBV-DNA阴性婴儿组(96·67%,P<0·05)。单独血清HBV-DNA阳性和UBMC同时阳性组1岁时HBV-DNA阳性率分别为11·11%和15·79%。结论:HBV能够感染新生儿PBMC,降低HBIG联和乙肝疫苗阻断垂直传播的效果。并因新生儿期的免疫耐受而造成HBV感染的持续与慢性化。
Objective： To investigate the infection ratio of hepatitis B virus （HBV） in peripheral blood monouclear cells （PBMC） of neonates with HBV infection and the effect of hepatitis B immune glohins （HBIG） and hepatitis B virus vaccine （HBVV） to prevent mother - baby HBV vertical transmission. Methods： 257 pregnant women with HBV infection were selected. When their infants were born, HBV - DNA was detected in umbilical blood serum and umbilical blood monocyte cells （UBMC）. To prevent HBV transmission of mother to baby, all neonates was injected HBIG 200 IU within 1 clay and on the 15th clay and HBVV at 1,2 and 7 month after birth respectively, When infants were 1 years old, HBsAb and HBV-DNA in serum were detected. Results： HBV- DNA positive ratio was 24. 18% in neonates UBMC of HBV - DNA positive pregnant women in serum, and it was lower than that in neonates＇serum of the same group （35. 29%, P 〈 0. 05）. After injected HBVV and HIGB, HBsAb positive ratio of HBV - DNA positive group in both umbilical blood serum and UBMC was lower than that of only umbilical blood serum positive group when infants were 1 years old （50. 00% vs 77. 78%, P 〈0. 05） . And they were lower than that of HBV - DNA negative group in both umbilical blood serum and UBMC （ 96. 67%, P 〈 0. 05 ） . In serum of 1 - yea - old infants, HBV - DNA positive ratio was 11.11% and 15.79% respectively in umbilical blood serum HBV - DNA positive group and both umbilical blood serum and UBMC positive group. Conclusion： PBMC of neonates may be infected by HBV, and this can depress the effect of preventing HBV transmission of mother to infant by HBIG and HBVV. Thus, the chronic and lasting HBV infection would be formed because of neonatal immune tolerance.
出处
《中国妇幼保健》
CAS
北大核心
2007年第13期1774-1776,共3页
Maternal and Child Health Care of China
基金
山东省卫生厅2003年科研项目
济宁市科技局2002年医学卫生科研项目(27号)
