乙型肝炎高危儿免疫预防效果及乙肝病毒母婴传播影响因素分析

黄歆; 周莉; 牟李红; 范捷; 蔡一玲

doi:10.7499/j.issn.1008-8830.2016.05.007

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中国当代儿科杂志 ›› 2016, Vol. 18 ›› Issue (5) : 410-414. DOI: 10.7499/j.issn.1008-8830.2016.05.007

论著·临床研究

乙型肝炎高危儿免疫预防效果及乙肝病毒母婴传播影响因素分析

黄歆¹, 周莉¹, 牟李红¹, 范捷¹, 蔡一玲²

作者信息 +

Efficacy of hepatitis B immunoprophylaxis in children at high risk of hepatitis B and risk factors for mother-to-child transmission of hepatitis B virus

HUANG Xin¹, ZHOU Li¹, MU Li-Hong¹, FAN Jie¹, CAI Yi-Ling²

Author information +

文章历史 +

摘要

目的分析乙型肝炎病毒(HBV)母婴传播影响因素及乙肝高危儿免疫预防的效果,为儿童乙肝防治提供科学依据。方法回顾性调查539例HBsAg阳性产妇及其6个月至5岁的乙肝高危儿551例,并检测乙肝高危儿的乙肝标志物,分析乙肝病毒母婴传播的影响因素。结果乙肝疫苗接种率为100%,96.6%联合注射了乙肝疫苗和乙肝免疫球蛋白(HBIG)。各年龄段乙肝高危儿的HBsAg阳性率差异无统计学意义;HBsAb阳性率随年龄增长逐步下降 (P<0.01)。高危儿母亲为HBsAg、HBeAg双阳性者较单纯HBsAg阳性的乙肝感染率高 (15.1% vs 0.2%,P<0.01)。单纯接种乙肝疫苗的高危儿乙肝感染率 (28.6%)高于联合免疫注射者 (2.8%),P<0.01。结论乙肝高危儿HBsAb阳性率随年龄增高逐渐下降。母亲HBsAg、HBeAg双阳性和出生未联合免疫注射是乙肝病毒母婴传播的危险因素。

Abstract

Objective To investigate the risk factors for mother-to-child transmission of hepatitis B virus (HBV) and the efficacy of hepatitis B immunoprophylaxis in children at high risk of hepatitis B. Methods A questionnaire survey was performed on 539 HBsAg-positive mothers and their 551 children (aged from 6 months to 5 years) at high risk of hepatitis B. Serum markers of hepatitis B in the children at high risk of hepatitis B were measured. Univariate logistic regression analysis was used to investigate the risk factors for mother-to-child transmission of HBV. Results The rate of hepatitis B vaccination in the children at high risk of hepatitis B was 100%, and 96.6% received injections of hepatitis B vaccine and hepatitis B immunoglobulin (HBIG). The HBsAg positive rate showed no significant differences between different age groups. The HBsAb positive rate gradually decreased with the increasing age (P<0.01). The children born to HBsAg-and HBeAg-positive mothers had a significantly higher hepatitis B infection rate than those born to HBsAg-positive mothers (15.1% vs 0.2%; P<0.01). The high-risk children who received hepatitis B vaccination alone had a significantly higher hepatitis B infection rate than those who received both hepatitis B vaccine and HBIG injections (28.6% vs 2.8%; P<0.01). Conclusions The HBsAb positive rate gradually decreases with the increasing age in children at high risk of hepatitis B. Maternal HBsAg and HBeAg positivity and the absence of HBIG combined with hepatitis B vaccine injections for children at high risk of hepatitis B are the risk factors for mother-tochild transmission of HBV.

导出引用

黄歆, 周莉, 牟李红, 范捷, 蔡一玲. 乙型肝炎高危儿免疫预防效果及乙肝病毒母婴传播影响因素分析[J]. 中国当代儿科杂志. 2016, 18(5): 410-414 https://doi.org/10.7499/j.issn.1008-8830.2016.05.007

HUANG Xin, ZHOU Li, MU Li-Hong, FAN Jie, CAI Yi-Ling. Efficacy of hepatitis B immunoprophylaxis in children at high risk of hepatitis B and risk factors for mother-to-child transmission of hepatitis B virus[J]. Chinese Journal of Contemporary Pediatrics. 2016, 18(5): 410-414 https://doi.org/10.7499/j.issn.1008-8830.2016.05.007

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