摘要
目的探讨替诺福韦酯联合双重免疫方案阻断慢性乙型肝炎病毒(HBV)携带孕妇母婴病毒传播的临床效果。方法选取阳江市公共卫生医院2019年9月至2020年9月收治的70例慢性HBV携带孕妇作为研究对象,采用随机数字表法分为对照组与观察组,各35例,对照组孕期不给予抗病毒干预,观察组在孕24~28周口服替诺福韦酯直至分娩。两组新生儿出生后均给予双重免疫方案(乙型肝炎人免疫球蛋白200μg肌肉注射+重组乙型肝炎疫苗20μg,0、1、6个月程序肌肉注射)。比较两组孕妇肝功能指标、HBV DNA水平,新生儿HBV感染情况、新生儿情况及用药安全性。结果两组孕妇治疗前、分娩时丙氨酸转氨酶(ALT)、天冬氨酸转氨酶(AST)水平比较,差异无统计学意义(P>0.05)。治疗前,两组孕妇HBV DNA水平比较,差异无统计学意义(P>0.05);分娩时,观察组HBV DNA水平低于对照组,差异有统计学意义(P<0.05)。分娩时,治疗6、12个月,观察组乙型肝炎表面抗原(HBsAg)阳性率、HBV阳性率均低于对照组,差异有统计学意义(P<0.05)。两组新生儿Apgar评分比较,差异无统计学意义(P>0.05)。两组孕妇均未发生明显不良反应。结论替诺福韦酯联合双重免疫方案阻断HBV携带孕妇母婴病毒传播效果显著,能有效降低分娩时HBV DNA水平,降低新生儿HBV感染率,安全性高。
Objective To investigate the clinical effect of Tenofovir Dipivoxil combined with dual immunization regimen in blocking the transmission of mother-to-child from pregnant women with chronic hepatitis B virus(HBV).Methods A total of 70 pregnant women with HBV who were admitted to Yangjiang Public Health Hospital from September 2019 to September 2020 were selected as the research subjects.They were divided into control group and observation group according to random number table method,with 35 cases in each group.The control group was not given anti-antibiotics during pregnancy.The observation group took Tenofovir Dipivoxil at 24 to 28 week of gestation until delivery.Both groups of newborns were given a dual immunization program after birth(Hepatitis B Human Immunoglobulin 200μg intramuscular injection+Recombinant Hepatitis B Vaccine 20μg intramuscular injection at 0,1 and 6 month).The liver function indexes,HBV DNA levels,newborn HBV infection status,newborn conditions and drug safety were compared between the two groups.Results There were no significant differences in the levels of alanine aminotransferase(ALT)and aspartate aminotransferase(AST)between the two groups before treatment and during delivery(P>0.05).There was no significant difference in the HBV DNA between the two groups before treatment(P>0.05).The HBV DNA level of the observation group was lower than that of the control group during delivery,and the difference was statistically significant(P<0.05).At delivery,after 6 and 12 months of treatment,the positive rates of hepatitis B surface antigen(HBsAg)and HBV in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).There was no significant difference in Apgar score between the two groups(P>0.05).No significant adverse reactions occurred in two groups.Conclusion Tenofovir Dipivoxil combine with dual immunization program has a significant effect in blocking the transmission of mother-to-child from pregnant women with HBV virus.It ca
作者
姜先杏
洪永孟
陈兴
JIANG Xianxing;HONG Yongmeng;CHEN Xing(Department of Pharmacy,Yangjiang Public Health Hospital,Guangdong Province,Yangjiang529500,China)
出处
《中国当代医药》
CAS
2022年第17期66-69,共4页
China Modern Medicine
关键词
慢性乙型肝炎病毒
替诺福韦酯
乙型肝炎人免疫球蛋白
重组乙型肝炎疫苗
母婴传播
Chronic hepatitis B virus
Tenofovir Disoproxil
Hepatitis B Human Immunoglobulin
Recombinant Hepatitis B Vaccine
Mother-to-child transmission
