摘要
目的:观察被动免疫疗法联合抗病毒疗法对妊娠合并乙肝患者母婴阻断成功效果。方法:选取2019年1月-2020年1月本院收治的妊娠合并乙肝患者138例,数字表法随机分为单药治疗组、联合治疗组各69例。单药治疗组采用替诺福韦治疗,联合治疗组采用替诺福韦联合人乙型肝炎免疫球蛋白治疗。检测患者治疗前后乙型肝炎病毒(HBV)-DNA、谷氨酰转肽酶(GGT)、丙谷转氨酶(ALT)、谷草转氨酶(AST)水平。统计对比ALT复常率、HBV DNA转阴率、新生儿HBsAg阳性率、HBsAb阳性率、HBV DNA阳性率以及母婴阻断成功率,新生儿并发症情况。结果:治疗后两组血清AST、GGT水平均降低且联合治疗组低于单药治疗组(P<0.05);与单药治疗组相比,联合治疗组血清ALT水平及HBV-DNA载量更低,ALT复常率(91.3%)、HBV-DNA转阴率(87.0%)、阻断率(97.1%)、HBsAb阳性率(97.1%)升高,HBsAg阳性率(0)、HBV-DNA阳性率(1.5%)、新生儿IgA、IgM、IgG水平以及并发症(2.9%)降低(P<0.05)。结论:采用被动免疫疗法联合抗病毒疗法治疗妊娠合并乙肝,可更有效降低患者血清中HBV-DNA水平,提高患者肝脏功能、免疫功能,提高ALT复常率、HBV DNA转阴率,改善新生儿免疫能力,降低新生儿并发症发生,母婴阻断效果更佳。
Objective:To explore the success effect of prevention of mother to child transmission(PMTCT)of passive immunotherapy combined with antiviral therapy for treating pregnant women with hepatitis B virus(HBV)infection.Methods:A total of 138 pregnant women with HB infection were selected and randomly divided into two groups(69 cases in each group)according to the number table method from January 2019 to January 2020.The women in group A were treated by tenofovir,and the women in group B were treated by tenofovir combined with immune globulin of HBV.The levels of HBV-DNA,gamma-glutamyl transferase(GGT),alanine transaminase(ALT),and aspartate transaminase(AST)of the women before and after treatment were measured.The ALT normalization rate,the HBV DNA negative rate,the neonatal HBsAg positive rate,the HBsAb positive rate,the HBV DNA positive rate,the success rate PMTCT,the neonatal complications situation of the women were statistics analyzed and were compared between the two groups.After treatment,the serum AST and GGT levels of the women in the two groups had decreased significantly,and which of the women in group B were significantly lower than those of the women in group A(P<0.05).The serum ALT level and HBV-DNA load of the women in group B were significantly lower than those of the women in group A.The ALT normalization rate(91.3%),the HBV-DNA negative rate(87.0%),the PMTCT rate(97.1%),and the HBsAb positive rate(97.1%)of the women in group B were significantly higher than those of the women in group A,and the HBsAg positive rate(0),the HBV-DNA positive rate(1.5%),the neonatal IgA,IgM,IgG levels,and the complications rate(2.9%)of the women in group B were significantly lower than those of the women in group A(P<0.05).Conclusion:Passive immunotherapy combined with antiviral therapy for treating pregnant women with HBV infection can reduce their serum HBV-DNA level,improve their liver function and immune function,and increase the rate of ALT recurrence and the HBV DNA negative conversion ratio of the women,and can imp
作者
吴秀秀
杜文玲
占思思
WU Xiuxiu;DU Wenling;ZHAN Sisi(Wenzhou Central Hospital,Zhejiang Province,325800)
出处
《中国计划生育学杂志》
2022年第2期306-310,共5页
Chinese Journal of Family Planning
关键词
妊娠合并乙肝
被动免疫疗法
抗病毒疗法
母婴阻断
Pregnant women with HBV infection
Passive immunotherapy
Antiviral therapy
Prevention of mother to child transmission
