摘要
目的:探讨母体注射乙肝免疫球蛋白(HBIG)阻断HBV母婴垂直传播的被动免疫效果和机制。方法:选取本院收治的慢性乙型病毒性肝炎孕产妇94例,随机分为对照组31例,婴儿干预组31例,和母婴共干预组32例;对照组不给予HBIG干预,婴儿干预组在婴儿出生6 h之内给予HBIG干预,母婴共干预组分别在母体孕28、32、36周和婴儿出生6 h之内给予HBIG干预;此外,三组新生儿均在出生后0、1、6月接种乙肝疫苗,并于末次接种后取患儿空腹外周血,进行乙肝标记物、HBV-DNA及免疫功能检测。结果:三组新生儿HBe Ag、HBs Ag、HBV-DNA阳性率有显著性差异(P<0.05),以对照组为最高,母婴共干预组最低;HBe Ab阳性率亦有显著性差异(P<0.05),以对照组为最低,母婴共干预组最高。三组新生儿的补体C3、C4水平及T淋巴细胞亚型CD3+T、CD4+T、CD8+T计数均有显著性差异(P<0.05),以对照组为最低,母婴共干预组最高;在免疫球蛋白方面,婴儿干预组和母婴共干预组的Ig G、Ig M显著高于对照组(P<0.05),而Ig A无明显组间差异(P<0.05)。结论:母体HBIG注射可有效激活母体的体液免疫和细胞免疫,降低母体中病毒含量。此外,通过胎盘对胎儿的影响,协同使新生儿产生抗原-抗体反应,缓解HBV病毒所诱发的T淋巴细胞耗损,有可能发挥其对HBV母婴垂直传播的阻断作用。
Objective： To discuss the passive immunity effect and mechanism of HBIG injections to matrix to block the motherto-child vertical transmission of HBV. Methods： 94 cases of patients with chronic viral hepatitis were selected and divided into 3 groups randomly. 31 cases of control group were given no HBIG intervention,while 31 cases of baby intervention（ BBI） group were given HBIG injection in 6h of birth,and 32 cases of infant mom intervention（ IMI） group were given HBIG injection respectively in 28,32,36 weeks of gestation and 6h of birth. Further more,all newborns were vaccinated against hepatitis B in 0,1 and 6 months,after the last vaccination,peripheral blood of the children were extracted and detected for HBV markers,HBV-DNA and immune function. Results：There were significant difference（ P〈0. 05） in neonatal HBe Ag,HBs Ag and HBV-DNA positive rate for the three groups,with Control group got the highest while IMI group got the lowest; and there are also significant differences（ P〈0. 05） HBe Ab positive rate,with Control group got the lowest while IMI group got the highest. We also found that the complement（ C3,C4） levels and T cell subtypes（ CD3^＋,CD4^＋,CD8^＋） count of the three groups of newborns had significant differences too（ P〈0. 05）,with Control group got the lowest while IMI group got the highest; in terms of immunoglobulin,both the IMI and BBI group were higher in Ig G and Ig M level（ P〈0. 05）,while there was no obvious difference in Ig A between groups（ P〈0. 05）. Conclusion： Maternal HBIG injections can effectively activate the maternal humoral immunity and cellular immunity,resulting in the decrease of HBV. It can also improve newborn＇s antigenantibody response and relieve T lymphocytes loss induced by antiviral consumption through placenta,which may play great role in the passive immunity mechanism of blocking mother-to-fetus transmission.
出处
《中国免疫学杂志》
CAS
CSCD
北大核心
2015年第6期818-821,共4页
Chinese Journal of Immunology
关键词
乙肝免疫球蛋白
母体注射
被动免疫
母婴传播
Hepatitis B immune globulin
Maternal injection
Passive immunity
Mother-to-fetus transmission
