摘要
目的 观察育龄期女性孕期予富马酸替诺福韦二吡呋酯(TDF)行母婴阻断的乙型肝炎e抗原(HBeAg)转换率。方法 收集2019年1月—2022年6月赣州市第五人民医院收治的HBeAg阳性、高HBV-DNA载量的妊娠中晚期孕妇(孕24~28周)病例数据,按照纳入标准和排除标准进行筛选出60例有效病例,根据随机数字表法分为TDF组和对照组,每组30例。2组均采取常规保肝治疗与抗病毒治疗,在此基础上TDF组采用富马酸替诺福韦二吡呋酯片治疗。比较2组孕妇治疗4、8、12周后与产后4周的HBeAg转换率情况,孕妇治疗前与治疗4、8、12周后及产后4周HBV-DNA浓度、乙肝血清标志物[乙型肝炎表面抗原(HBsAg)、乙型肝炎表面抗体(HBsAb)]、肝功能指标[丙氨酸氨基转移酶(ALT)、天冬氨酸氨基转移酶(AST)]及肌酐水平。结果 TDF组在治疗4、8、12周后与产后4周的HBeAg转换率均高于对照组(P<0.05);治疗4、8、12周后与产后4周,2组HBV-DNA浓度、HBsAg、HBsAb水平较治疗前下降,且TDF组低于对照组(P均<0.01),而2组ALT、AST及肌酐水平治疗前后比较差异均无统计学意义(P>0.05)。结论 育龄期女性孕期行母婴阻断治疗时,在常规治疗基础上,口服富马酸替诺福韦二吡呋酯片可明显提高在治疗4、8、12周后与产后4周的HBeAg转换率,对于降低HBV-DNA浓度、乙肝血清标志物HBsAg、HBsAb效果显著,而对于孕妇肝功能、肾功能影响不明显。
Objective To observe the rate of HBeAg seroconversion in pregnant women of childbearing age during pregnancy who receive tenofovir disoproxil fumarate(TDF) for mother-to-child transmission prevention of HBV.Methods Clinical data of HBeAg positive and high HBV-DNA load pregnant women(24 to 28 weeks of pregnancy) admitted to Ganzhou Fifth People′s Hospital from January 2019 to June 2022 were collected,and 60 effective cases were screened according to inclusion and exclusion criteria.They were randomly divided into TDF group and control group,with 30 cases in each group.The two groups were treated with conventional liver protection therapy and antiviral therapy,and on this basis,the TDF group was treated with tenofovir disoproxil fumarate tablets.The HBeAg conversion rates,HBV-DNA concentration,serum markers of hepatitis B(HBsAg,HBsAb),liver function indexes(ALT,AST) and creatinine levels between the two groups after 4,8,12 weeks of treatment and 4 weeks after delivery were compared.Results The HBeAg conversion rates in the TDF group were higher than those in the control group after 4,8,12 weeks of treatment and 4 weeks after delivery,with significant differences between the two groups(P<0.05).After 4,8,12 weeks of treatment and 4 weeks after delivery,the HBV-DNA concentration,HBsAg and HBsAb levels of the two groups were lower than those before treatment,and the TDF group were lower than the control group(P<0.01).There was no significant difference in the levels of ALT,AST and creatinine between the two groups before and after treatment(P>0.05).Conclusion On the basis of routine treatment,oral tenofovir dipivoxil fumarate tablets can significantly increase the HBeAg conversion rates after 4,8,12 weeks of treatment and 4 weeks after delivery,which is ideal for reducing the HBV-DNA concentration,HBsAg and HBsAb,while it has no significant impact on the serum liver function and renal function of pregnant women.
作者
洪慧珍
蓝裕玲
吴田华
谢萍
龙丽娟
HONG Huizhen;LAN Yuling;WU Tianhua;XIE Ping;LONG Lijuan(Ganzhou Fifth People′s Hospital,Jiangxi Province,Ganzhou 341000,China)
出处
《临床合理用药杂志》
2024年第11期30-33,共4页
Chinese Journal of Clinical Rational Drug Use
基金
赣州市卫生健康委员会项目(2022-2-127)。
关键词
育龄期女性
孕期口服
富马酸替诺福韦二吡呋酯片
母婴阻断
HBeAg转换率
Women of childbearing age
Oral administration during pregnancy
Tenofovir dipivoxil fumarate tablets
Maternal infant blockade
HBeAg conversion rate