Is globulin of second liver immunity hit? Do not hit?

Nbsp;nbsp;nbsp;nbsp; our country is area of hepatitis B tall hair, have 1. Sicken of 200 million person; And in a variety of causes that cause this one astonishing number, mother baby transmission is the mainest -- , the patient that has 40% because this catch a disease. This brought an issue: How should we break transmission of baby of second liver mother to assure the child's health through block, thereby pick off " second liver big country " cap? Come for years, the method of the globulin of immunity of liver of second of pregnant woman inject that a lot of hospitals collected draw to affect second liver, but, as a result of a variety of reasons, this kind of practice suffers controversy all the time in academia. Recently, ministry of medicine of academician of Chinese Academy of Engineering, Beijing University teachs Zhuang Hui to prevent height forum to went up to put forward crosscurrent clearly in hepatitis B immunity, make this problem makes the central point of attention again. Is globulin of second liver immunity used very generally what is globulin of immunity of 　 second liver? Be in hospital of Beijing ground altar, dr Li Ping of department of gynaecology and obstetrics tells a reporter, immune globulin is the normal material inside human body actually, it can counteract the cause of disease that enters human body microbial, include bacterium and virus. Globulin of second liver immunity is extracted from inside the blood of normal person, have the capacity of virus of liver of the second in counteracting blood. "This from begin to use 10 years ago. " she says, pregnant woman is pregnant 28 weeks or so begin to hit globulin of second liver immunity, it can enter fetal system inside, neutralize the second liver virus that enters fetal blood, reduce the odds that affects inside second liver palace greatly. When the reporter asked about the person that whether comes here to use globulin of second liver immunity, dr Li Ping says: "The pregnant woman great majority that come here was used. It is right ' small 3 this world ' block is broken rate amount to 95% , right ' big 3 this world ' the possibility is a bit a few smaller. " nevertheless, she did not tell a reporter whether this is normal statistical number. Reporter phone contacted university of traffic of director of institute of hepatitis of Xi'an traffic university, Xi'an the first hospital infects division director Zhang Shulin, he is home one of experts that study globulin of second liver immunity earlier. Professor Zhang expresses, he is from what begin to undertake globulin of second liver immunity studies 15 years ago, and home is large-scale using is from 1995, the left and right sides began 1997, "Current, the method that total national capital had used the pregnant woman that gives infection second liver to hit immune globulin " . Guideline of second liver prevention and cure did not make conclusions a doctor of 302 hospitals is accepting 　 liberation army when the reporter is interviewed, say, it is the second liver that announces according to the country to affecting the pregnant woman of second liver to use immune globulin guideline of prevention and cure comes, announce inside countrywide limits use a kind of drug, showing it is " well-founded, not be blind " . But, the situation that the reporter understands is not however such. Last year year end, branch of epidemiology of China cure society and liver ill credit can roll out Chinese head ministry " guideline of prevention and cure of chronic hepatitis B " , the prevention and cure of liver giving second placed reference standard. But the reporter notices, the pregnant woman that this guideline did not allude to affect second liver hits immune globulin this one. Si Chongwen of professor of division of disease of infection of the first hospital tells committee member of advisory committee of expert of hepatitis of sex of virus of Ministry of Public Health, Beijing University the reporter, because academia is too intense to the controversy of this one problem,this is, do not have final conclusion temporarily so. Academia debate is intense 　 controversy has many intense, why and controversy? The reporter in interviewing discovers, the controversy basically centers in the following: One, authority is recommended. Professor Zhuang Hui tells a reporter, ministry of Public Health of World Health Organization, our country and the professional society that second liver prevents and cure did not recommend the method that will prevent baby of second liver mother to travel through giving pregnant woman inject immunity globulin, other country never also has taken this kind of way. But Professor Zhang Shulin thinks, second liver patient basically is in China centrally, it is very normal that foreign He Shiwei was not recommended. Did not recommend as to our country Ministry of Public Health, still basically lack the support of test data. 2, clinical trial. Respecting this, professor Si Chongwen thinks, lack " evidence " be " globulin of immunity of liver of second of pregnant woman inject " one of keys that inadequacy is a letter. To this, professor Zhang Shulin also admits, still do not have at present strict according to medicines and chemical reagents clinical trial administers a standard (GCP) the action that the experiment of the travel that enter 　 will come to prove to hit immune globulin to travel to preventing second liver Mu Ying to pregnant woman, more returning is " it is severally blast " small-scale test. "The hope can have brushstroke fund, make us OK undertake large-scale random double blind contrasts experiment " . 3, material curative effect. Although lack experiment support, but Professor Zhang Shulin emphasizes: The second liver block of globulin of immunity of use second liver is broken businesslike taller than what did not use. According to report of Xinhua News Agency, 2000, fudan University college of medicine is accessary and paediatrics the Zhu Qi of the hospital the professor ever pointed out when the way that puts forward to hit immune globulin to pregnant woman, be pregnant oneself 28 weeks rise, the puerpera hits stitch immunity globulin every months, rate of the infection inside second liver palace of the baby is met by 14 original. 7 ％ drop 5. 7 ％ . Nevertheless, professor Zhuang Hui points out in the letter that gives a reporter: To liver transplanting patient, its are hepatic (the main room with second liver duplicate virus) already was excised, below this kind of circumstance, euramerican country still suggests: Have a relapse to prevent second liver, should inject in the operation immune globulin 10000 international unit (the dosage that far outclass home injects to pregnant woman) , and inject even for long after art, be in in order to make antibody of surface of liver of the second in blood is maintained be more than 100, the level of 500 international unit. Although such, still have recrudesce of liver of second of patient of transplanting of one part liver. The liver of pregnant woman was not excised, virus still duplicates in great quantities inside liver, the dosage of globulin of second liver immunity of inject very low, remove block impossibly to decide the effect that Mu Ying spreads. 4, virus mutates. In interview, professor Zhuang Hui and Professor Si Chongwen point out, evidence shows, to patient of liver, kidney transplant globulin of immunity of liver of many inject second is met bring about virus to mutate, the likelihood makes " active vaccine cannot prevent second liver " . But Professor Zhang Shulin thinks, the quantity of the immune globulin that injects to patient of liver, kidney transplant and the amount that inject to pregnant woman are different. So old come, did not hear of because inject immunity globulin appears,have pregnant woman harmful response or cause infantile growth undesirable, more " the effectiveness that won't reduce vaccine " . 5, affect a way. This is the another core issue that should give pregnant woman inject immunity globulin. Professor Si Chongwen points out, understand according to him, in transmission of baby of second liver mother 95% it is to produce haemal infection, having 5% only is the infection inside palace -- , former through giving a baby inject vaccine and immune globulin, can have very good precaution effect, latter is the reason place that a lot of doctors make immune globulin to pregnant woman, think immune globulin can rise to prevent the action that influences inside palace. But Professor Zhang Shulin thinks, judge standard differs as a result. They are passed detect ribonucleic acid of to oxigenate of second liver virus (HBVDNA) discovery, the proportion that affects inside palace is as high as nearly 40% actually. Unite an opinion: Should hit 　 look back on to the baby, to globulin of second liver immunity, didn't academia unite a view really? The reporter understands, although be opposite,the pregnant woman that affects second liver should make exception of immune globulin existence, but experts think consistently: Should hit to the baby. Professor Zhuang Hui points out, if the mother affects second liver, new student 24 hours of a person operating from within in coordination with outside forces after be born inject as early as possible immune globulin, at the same time 10 microgramme recombine have an inoculation yeasty or liver of 20 microgramme second is vaccinal, such can effective block break transmission of baby of second liver mother. Can be born in the child additionally hind globulin of 1 needle immunity injects first inside 12 hours, the 2nd needle injects again after a month, at the same time vaccinal 10 microgramme recombine 1 needle yeasty or 20 microgramme are vaccinal, lie between a month and 6 months to part again vaccinal, before block breaks rate comparing one kind of measure is expensive. He still expresses, if new student in be born 12 hours inside injected immune globulin and vaccine, can accept maternal lactation. "Now is a child, hope can healthy. " in interviewing, professor Si Chongwen says to the reporter, be this kind of state of mind, the mother that lets many infection second liver chose to hit immune globulin before production. This also is one of reasons that this kind of therapeutics is able to popularize quickly. But, in view of lack credible test data, "Our manner still is to be not encouraged " . (responsibility edits: Zhang Jiong smooth)