本文選題：乙肝病毒 + 母嬰阻斷��； 參考：《中國公共衛(wèi)生》2017年12期

【摘要】：目的了解云南省乙肝表面抗原(HBsAg)陽性孕產(chǎn)婦所生嬰兒在實(shí)施母嬰阻斷后的免疫應(yīng)答及乙肝感染狀況。方法篩查出全云南省2011年1—6月入院分娩的HBsAg陽性孕產(chǎn)婦,實(shí)施母嬰阻斷后以其所生嬰兒為調(diào)查對(duì)象,于7—12月齡采集靜脈血2 mL,分離出血清標(biāo)本先統(tǒng)一采用ELISA法做乙肝血清學(xué)5項(xiàng)指標(biāo)檢測,篩選出HBsAg陽性的標(biāo)本采用熒光定量PCR法進(jìn)行乙肝病毒載量(HBV DNA)檢測,篩選出HBsAg陰性且乙肝表面抗體(anti-HBs,抗-HBs)陽性的標(biāo)本采用化學(xué)發(fā)光法做抗-HBs定量檢測。結(jié)果共收集到調(diào)查對(duì)象3 026人,母嬰阻斷實(shí)施后免疫應(yīng)答率為92.43%,有效免疫應(yīng)答率為80.04%;低、無免疫應(yīng)答者占16.09%;母嬰阻斷失敗率為3.87%。本次調(diào)查共檢出10種乙肝血清標(biāo)志物組合模式,檢出率最高為模式6,占74.62%:其次為模式5,占14.44%:再次為模式7,占3.70%:模式4占3.37%。母嬰阻斷失敗組中,HBV DAN含量5×10~7IU/mL占45.30%;500~5×10~7IU/mL占39.32%;500 IU/mL占15.38%;HBeAg陽性率為79.49%。產(chǎn)生免疫應(yīng)答組檢出3種血清組合模式,乙肝病毒e抗體(anti-HBe,抗-HBe)陽性率為3.79%,乙肝病毒核心抗體(anti-HBc,抗-HBc)陽性率為23.20%。定量檢測抗-HBs,抗體水平1 000 mIU/mL的高免疫應(yīng)答者占66.93%,抗體水平在100~1 000 mIU/mL的中免疫應(yīng)答者占19.66%,抗體水平在10~100 mIU/mL的低免疫應(yīng)答者占13.41%。經(jīng)統(tǒng)計(jì)分析,產(chǎn)生免疫應(yīng)答抗-HBs的抗體水平高低與嬰兒體內(nèi)是否攜帶抗-HBe、抗-HBc及性別無關(guān)。結(jié)論對(duì)HBsAg陽性孕產(chǎn)婦所生嬰兒實(shí)施母嬰阻斷,并建立健全產(chǎn)后對(duì)嬰兒追蹤機(jī)制,對(duì)預(yù)防和控制嬰兒感染乙肝起關(guān)鍵作用。
[Abstract]:Objective to investigate the immune response and hepatitis B infection of infants born to pregnant women with hepatitis B surface antigen (HBsAg) positive in Yunnan province. Methods HBsAg positive pregnant women were screened out from January to June 2011 in Yunnan Province, and their infants were selected as the objects of investigation after maternal and infant block. Venous blood samples were collected from 7 to 12 months of age. Serum samples were collected for HBV serological detection by Elisa, and HBV DNA was detected by fluorescence quantitative PCR (FQ-PCR) in HBsAg positive samples. HBsAg negative and anti-HBs (anti-HBsAg) positive specimens were detected quantitatively by chemiluminescence. Results A total of 3 026 subjects were collected, the immune response rate was 92.43, the effective immune response rate was 80.04, the low immune response rate was 16.09, and the maternal and infant blocking failure rate was 3.87. Ten HBV serum markers combination models were found in this survey. The highest detection rate was mode 6 (74.62%), followed by mode 5 (14.44%), mode 7 again (3.70%) and mode 4 (3.37%). In the failed group, the concentration of HBV DAN was 45.30% (55.30%) and 5005 脳 10 7 / mL (39.32ml / mL). The positive rate of HBeAg was 79.49% (P < 0.05). In the immune response group, the positive rates of anti-HBe3.79 and anti-HBc, anti-HBc were 3.79 and 23.20g, respectively. In quantitative detection of anti-HBs, the proportion of high immune responders was 66.93 with the antibody level of 1 000 mIUs / mL, 19.66 with antibody level of 100 ~ 1 000 mIUs / mL, and 13.41 with low immune response with antibody level of 10 ~ 100 mIU- / mL. According to statistical analysis, the level of anti-HBs produced in immune response was not related to whether the infant carried anti--HBe, anti-HBc and sex. Conclusion the prevention and control of hepatitis B infection in infants with HBsAg positive pregnant women is crucial to the prevention and control of infantile infection by blocking the mother and infant, and establishing and perfecting the tracking mechanism of infants after delivery.
【作者單位】： 云南省疾病預(yù)防控制中心免疫規(guī)劃所;中國疾病預(yù)防控制中心病毒病預(yù)防控制所肝炎室;
【分類號(hào)】：R714.251
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本文編號(hào)：2017239