摘要
目的探讨孕期女性服用替比夫定后阻断慢性乙肝母婴传播研究及其安全性分析。方法 92例中晚期妊娠合并乙肝孕妇患者随机分为实验组和对照组,每组46例。实验组孕妇患者在28孕周开始,每天服用替比夫定片,产后继续治疗半年,对照组孕妇患者不服用抗病毒药物,对比孕妇患者入院时与分娩前HBV-DNA转阴率及ALT复常率;新生儿给予乙肝免疫球蛋白及乙肝疫苗注射治疗,对新生儿HBs Ag进行检测并采用Apgar评分了解新生儿的发育情况。结果与治疗前对比,实验组患者ALT、HBV-DNA等指标明显下降,其中实验组各指标下降幅度明显低于对照组,差异有统计学意义(P<0.05)。实验组新生儿在出生时、出生后6、12个月的HBV-DNA阳性率分别为10.87%、2.17%、0;对照组分别为28.26%、21.74%、13.0%,差异有统计学意义(P<0.05)。实验组新生儿在出生时、出生后6、12个月的HBs Ag阳性率分别为8.7%、4.35%、2.17%;对照组分别为32.61%、23.9%、15.22%,差异有统计学意义(P<0.05)。两组新生儿Apgar评分无明显差异。结论替比夫定不仅是治疗孕妇慢性乙肝患者的有效药物,并可阻断母婴间HBV垂直传播且对母婴安全性高,值得临床广泛应用。
Objective To evaluate the blocking effect of telbivudine on mother-to-infant transformation of pregnant women with chronic hepatitis B virus and its safety analysis after the telbivudine therapy. Methods Ninety-two cases of pregnant women with chronic hepatitis B virus were divided into two groups, forty-six of treatment group and forty-six of control group. Pregnant women in the treatment group were treated with telbivudine 600 mg/d since 28 weeks and lasting for half a year, while the pregnant women in the control group did not take any antiviral drugs, and then comparing the HBV-DNA negative transformation rate and ALT recovery rate of pregnant women before in hospital and giving birth. Babies were injected with HBIG and hepatitis B vaccine. The HBs Ag were detected and the developments of the new babies were observed with the use of Apgar score. Results The ALT and HBV-DNA levels were descended of pregnant women with chronic hepatitis B virus after treated with telbivudine, the values of the descending of the treatment group was significantly lower than the control group（P〈0.05）. In the treatment group, when new babies were born, 6, and 12 months old, the positive rates of HBV-DNA were 10.87%, 2.17%, 0; the positive rates of the control group were 28.26%, 21.74%, 13.0%（P〈0.05）. In the treatment group, when new babies were born, 6, and 12 months old, the positive rates of HBs Ag were 8.7%、4.35%、2.17%; the positive rates of the control group were 32.61%、23.9%、15.22%（P〈0.05）. There were no significant differences in the Apgar scores of new babies of two groups. Conclusion Telbivudine is not only effective in treatment of pregnant women with chronic hepatitis B virus but also block mother-to-infant transformation, which was safer and will be widely applied in clinical.
出处
《中国医药科学》
2015年第16期7-9,62,共4页
China Medicine And Pharmacy
基金
国家十二五"艾滋病和病毒性肝炎等重大传染病防治"科技重大专项子课题(2012ZX10004301-005)
关键词
替比夫定
慢性乙型肝炎
母婴传播
安全
Telbivudine
Chronic hepatitis B virus
Mother-to-infant transformation
Safe
