377例新生兒乙肝病毒母嬰傳播阻斷效果及相關(guān)因素分析
發(fā)布時間:2018-05-08 05:25
本文選題:乙型肝炎病毒 + 母嬰傳播 ; 參考:《現(xiàn)代預(yù)防醫(yī)學(xué)》2017年13期
【摘要】:目的研究乙肝免疫球蛋白(hepatitis B immunoglobulin,HBIG)和10μg重組酵母乙肝疫苗(hepatitis B vaccine,Hep B)聯(lián)合應(yīng)用阻斷乙肝病毒(hepatitis B virus,HBV)母嬰傳播效果。方法 2013-2015年以居住在北京市海淀區(qū)、乙肝表面抗原(hepatitis B surface antigen,HBsAg)陽性母親所生、出生時進行過HBV母嬰阻斷的兒童為研究對象。通過問卷獲得被調(diào)查兒童的人口學(xué)狀況、出生醫(yī)院、HBIG和Hep B接種情況,以及母親分娩前乙肝e抗原情況。采集兒童靜脈血標(biāo)本5ml,檢測HBsAg、乙肝表面抗體(hepatitis B surface antibody,抗-HBs)、乙肝核心抗體(hepatitis B surface antibody,抗-HBc)。計算不同特征兒童的HBsAg和抗-HBs陽性率,并比較其差異。結(jié)果共納入分析兒童377人,HBsAg均為陰性,抗-HBs陽性率為91.25%(344/377)。單因素分析顯示,采血距第3劑Hep B(Hep B3)不同間隔兒童抗-HBs陽性率(94.72%VS 70.91%)差異有統(tǒng)計學(xué)意義(校正=30.432,P0.001);多因素logistic回歸分析顯示,抗-HBs是否陽性與HBIG接種劑量和采血距第3劑Hep B(Hep B3)間隔時間有關(guān),與出生時接種100IU HBIG的兒童(92.56%)相比,接種200IU的兒童抗-HBs陽性率(85.29%)低(OR=0.352,95%CI:0.148~0.834,P=0.018);與采血距Hep B3間隔3年兒童(94.72%)相比,采血間隔≥3年兒童的抗-HBs陽性率(70.91%)低(OR=0.119,95%CI:0.054~0.262,P0.001)。結(jié)論≥100IU HBIG和10μg重組酵母Hep B聯(lián)合應(yīng)用可有效阻斷HBV母嬰傳播;兒童抗-HBs陽性率隨時間下降,特別是3年后下降較明顯,需對HBsAg陽性母親所生兒童進行HBV血清學(xué)監(jiān)測,根據(jù)結(jié)果決定是否需要加強免疫。
[Abstract]:Objective to study the effect of hepatitis B immunoglobulin B (HBIGG) combined with 10 渭 g recombinant yeast hepatitis B vaccine (hepatitis B accine Hep Bep) on blocking mother-to-child transmission of hepatitis B virus (HBV). Methods Children who were born with hepatitis B surface antigen-HBsAg positive mothers living in Haidian District of Beijing from 2013 to 2015 and who had been blocked from mother to child by HBV were studied. The demographic status of the children, the inoculation of HBIG and Hep B in the birth hospital, and the hepatitis B antigen before delivery were obtained by questionnaire. The blood samples of children were collected to detect HBsAg, hepatitis B surface antibody, anti-HBsAg, hepatitis B surface antibody, anti-HBcTc. The positive rates of HBsAg and anti-HBs in children with different characteristics were calculated and compared. Results all 377 children were negative for HBsAg, and the positive rate of anti-HBs was 91.25%. Univariate analysis showed that the positive rate of anti-HBs was 94.72VS70.91in children with different intervals from the 3rd dose of Hep B(Hep B3). The positive rate of anti-HBs in the children inoculated with 200IU was lower than that in children inoculated with 200IU 0.352c95CIW 0.1480.34P0.01818, compared with the children who took blood from Hep B3 three years later, compared with the children who took blood at the interval of 3 years from Hep B3, the positive rate of anti-HBs in the children inoculated with 200IU was lower than that of the children who took blood from Hep B3. The positive rate of anti-HBs in children with blood sampling interval 鈮,
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