乙型肝炎的母婴传播影响因素及阻断方法的研究进展
Research Progress on Influencing Factors of Mother-to-Child Transmission of Hepatitis B
DOI: 10.12677/ACM.2021.111060, PDF,    科研立项经费支持
作者: 张改霞*, 万 苗, 赵 睿：延安大学附属医院妇产科，陕西 延安；李 丽#：延安大学附属医院产科，陕西 延安
关键词: 乙型肝炎病毒；母婴传播；影响因素；Hepatitis B Virus； Mother-to-Child Transmission； Influencing Factors
摘要: 影响乙型肝炎病毒母婴传播的因素较多，针对不同影响因素采取相应干预措施，降低乙肝母婴传播率。其中新生儿采用主被动联合免疫可大大降低母婴传播率。孕妇高HBV DNA水平是其中最重要的影响因素，故建议孕晚期对需要治疗的孕妇采取抗病毒治疗。母乳喂养及分娩方式不会增加乙肝母婴传播风险。还有部分影响因素需进一步研究。
Abstract: There are many factors affecting the mother-to-child transmission of hepatitis B, and corresponding measures should be taken to reduce the infection rate of mother-to-child transmission of hepatitis B. Among them, active and passive combined immunization can greatly reduce the rate of mother-to-child transmission. High HBV DNA level in pregnant women is the most important factor, so it is suggested that antiviral treatment should be taken for pregnant women in late pregnancy. Breastfeeding and mode of delivery do not increase the risk of mother-to-child transmission of hepatitis B. There are still some factors needed to be further studied.
文章引用：张改霞, 万苗, 李丽, 赵睿. 乙型肝炎的母婴传播影响因素及阻断方法的研究进展[J]. 临床医学进展, 2021, 11(1): 425-430. https://doi.org/10.12677/ACM.2021.111060

参考文献

[1] 王贵强, 王福生, 成军, 等. 慢性乙型肝炎防治指南(2015年版) [J]. 中华实验和临床感染病杂志(电子版), 2015, 9(5): 570-589.
[2] 冯珍珍, 卢安, 王丽芳. 乙肝病毒宫内感染机制及危险因素的研究进展[J]. 临床输血与检验, 2015, 17(3): 286-288.
[3] 张清, 资捷, 刘萍, 等. 乙肝病毒宫内感染临床诊断研究[J]. 中国热带医学, 2010, 10(5): 540-541, 583.
[4] Zhang, L., Gui, X., Wang, B., et al. (2016) Serological Positive Markers of Hepatitis B Virus in Femoral Venous Blood or Umbilical Cord Blood Should Not Be Evidence of In-Utero Infection among Neonates. BMC Infectious Diseases, 16, 408. [Google Scholar] [CrossRef] [PubMed]
[5] 王璐, 代晶芳, 张国梅. HBV高病毒载量孕妇与新生儿宫内感染的相关性分析[J]. 中华医院感染学杂志, 2018, 28(4): 586-589, 597.
[6] Guo, Z., et al. (2013) Risk Factors of HBV Intrauterine Transmission among HBsAg-Positive Pregnant Women. Journal of Viral Hepatitis, 20, 317-321. [Google Scholar] [CrossRef] [PubMed]
[7] Chen, T.Y., Wang, J., Qiu, H.T., et al. (2018) Different Interventional Criteria for Chronic Hepatitis B Pregnant Women with HBeAg(+) or HBeAg(−) Epidemiological Data from Shaanxi, China. Medicine, 97, e11406. [Google Scholar] [CrossRef] 
[8] Li, Z.X., Hou, X.M. and Cao, G.W. (2015) Is Mother-to-Infant Transmission the Most Important Factor for Persistent HBV Infection? Emerging Microbes & Infections, 4, e30. [Google Scholar] [CrossRef] [PubMed]
[9] 杨松静, 黄桢翔, 陈碧钦, 等. 孕妇乙型肝炎病毒宫内感染相关危险因素研究[J]. 中华疾病控制杂志, 2017, 21(1): 44-47.
[10] 黄睿, 曹引丽, 高洁, 等. 西安市HBV宫内感染的发生情况及其影响因素研究[J]. 华南预防医学, 2017, 43(6): 507-511.
[11] Liu, J.F., Feng, Y.L., Wang, J., et al. (2015) An “Immune Barrier” Is Formed in the Placenta by Hepatitis B Immunoglobulin to Protect the Fetus from Hepatitis B Virus Infection from the Mother. Human Vaccines & Immunotherapeutics, 11, 2068-2076. [Google Scholar] [CrossRef] [PubMed]
[12] 邹怀宾, 陈煜, 段钟平, 张华. HBeAg阳性孕妇孕晚期注射HBIG阻断HBV母婴传播研究[C]//第6届全国疑难及重症肝病大会论文集, 2011.
[13] 郭树平. 乙肝免疫球蛋白联合乙肝疫苗阻断乙肝母婴传播的疗效分析[J]. 临床合理用药杂志, 2019, 12(1): 110-112.
[14] Gong, J.L. and Liu, X. (2018) Effect of HBIG Combined with Hepatitis B Vaccine on Blocking HBV Transmission between Mother and Infant and Its Effect on Immune Cells. Experimental and Therapeutic Medicine, 15, 919-923. [Google Scholar] [CrossRef] [PubMed]
[15] Li, W., et al. (2018) Efficacy and Safety of Tenofovir in Preventing Mother-to-Infant Transmission of Hepatitis B Virus: A Meta-Analysis Based on 6 Studies from China and 3 Studies from Other Countries. BMC Gastroenterology, 18, 121. [Google Scholar] [CrossRef] [PubMed]
[16] Sun, W., Zhao, S., Ma, L., et al. (2017) Telbivudine Treatment Started in Early and Middle Pregnancy Completely Blocks HBV Vertical Transmission. BMC Gastroenterology, 17, 51. [Google Scholar] [CrossRef] [PubMed]
[17] 邱波, 朱玲, 陈艳, 等. 妊娠期不同阶段给予替比夫定阻断乙型肝炎病毒宫内母婴传播的研究[J]. 实用肝脏病杂志, 2016, 19(4): 428-431.
[18] 陆全银. 孕晚期抗病毒药物联合免疫球蛋白注射阻断乙型肝炎母婴传播效果及影响因素分析[J]. 河南预防医学杂志, 2016, 27(3): 171-173, 176.
[19] 王栋平, 周文慧, 吕文良. 乙型肝炎病毒母婴传播阻断的研究进展[J]. 中国病毒病杂志, 2017, 7(1): 73-77.
[20] 谭烈明, 刘琳. 在联合免疫阻断下分娩方式对乙型肝炎病毒母婴传播的影响观察[J]. 世界最新医学信息文摘, 2018, 18(64): 8-9.
[21] 周翔, 刘雷, 孙巧丽. 分娩方式对我国乙型肝炎病毒母婴传播影响的Meta分析[J]. 中国热带医学, 2016, 16(3): 240-243.
[22] 张四华. 阴道分娩与剖宫产在乙型肝炎母婴传播阻断中的应用效果比较[J]. 首都食品与医药, 2018, 25(23): 15.
[23] 张小兰, 陈晓艳, 汤素文. 分娩方式与乙型肝炎病毒母婴传播阻断的相关性研究[J]. 现代妇产科进展, 2017, 26(1): 64-66.
[24] 黄慧. 不同喂养方式对乙型肝炎病毒感染产妇母婴传播的影响[J]. 肝脏, 2019, 24(4): 477-478.
[25] 王萌, 王小丽, 李锋. 227例乙型肝炎病毒表面抗原阳性母亲所生儿童血清学调查[J]. 河南预防医学杂志, 2018, 29(6): 428-430.
[26] 黄敏, 周海新, 郑粼. 探讨免疫预防乙型肝炎病毒母婴传播的效果及影响因素[J]. 中华医院感染学杂志, 2018, 28(17): 2670-2672, 2676.
[27] 朱索宇, 韩国荣, 蒋美琴. 乙型肝炎人免疫球蛋白联合乙肝疫苗阻断乙肝病毒母婴传播的疗效观察[J]. 中国实用医药, 2016, 11(28): 193-194.
[28] 金美玉, 全顺爱, 郑世梅, 等. 乙型肝炎免疫球蛋白联合乙型肝炎疫苗阻断乙型肝炎病毒母婴传播的研究[J]. 中华医院感染学杂志, 2016, 26(10): 2354-2356.
[29] 刘桂芬, 焦春秀. 新生儿乙型肝炎病毒母婴传播早期干预研究[J]. 中国现代医生, 2016, 54(3): 56-59.
[30] 刘晓霞, 杨安华, 王晓琼, 等. 10μg和5μg乙型肝炎疫苗与乙型肝炎免疫球蛋白联合免疫阻断乙型肝炎病毒母婴传播的效果观察[J]. 中国疫苗和免疫, 2018, 24(4): 393-396.
[31] 朱海艳. 乙肝疫苗与乙肝免疫球蛋白联合对预防母婴传播乙型肝炎的临床效果观察[J]. 实用妇科内分泌杂志(电子版), 2017, 4(23): 61-62.
[32] Wang, C., Wang, C., Jia, Z.F., et al. (2016) Protective Effect of an Improved Immunization Practice of Mother-to-Infant Transmission of Hepatitis B Virus and Risk Factors Associated with Immunoprophylaxis Failure. Medicine, 95, e4390. [Google Scholar] [CrossRef] 
[33] 王翠兰. 新生儿首针乙肝疫苗接种状况调查分析[J]. 中国卫生标准管理, 2017, 8(27): 4-6.

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