|
摘要：
|
|
摘要：目的 评价妊娠晚期口服替诺福韦（tenofovir，TDF）对HBV DNA高载量孕妇母婴垂直传播的阻
断疗效和安全性。方法 选取2014年8月至2016年12月于吉林省肝胆病医院母婴阻断门诊检查的符合纳入
排除标准的200例HBV DNA高载量（HBV DNA ＞ 1.0 × 10 6 IU/ml）孕妇为研究对象。根据干预方案分
为治疗组（128例）和对照组（72例）。治疗组孕妇在孕28周口服TDF直至产后4周，对照组孕妇在妊娠
期未接受抗病毒药物治疗。两组新生儿在出生后均接种乙肝免疫球蛋白和乙肝疫苗主被动联合免疫。
比较两组孕妇在分娩时和分娩后12周血清HBV DNA载量。评估两组新生儿在28周龄时血清HBsAg、
HBeAg及HBV DNA阳性率，并比较两组新生儿出生时胎龄、身长、头围、体质量和Apgar评分。结果
治疗组孕妇分娩前血清HBV DNA为（4.79 ± 0.89）IU/ml，显著低于对照组[（7.60 ± 0.73）IU/ml] 和治
疗前 [（7.87 ± 0.51） IU/ml]（P ＜ 0.05）。新生儿28周龄时，治疗组HBV感染率为0.0%，显著低于对照
组的5.6%（χ 2 = 7.256，P = 0.007）。两组新生儿出生时胎龄、身长、头围、体质量和Apgar评分差异无
统计学意义（P ＜ 0.05）；两组孕妇早产率、产后出血率、剖宫产率和分娩时血清肌酸激酶（creatine
kinase，CK）差异无统计学意义（P ＜ 0.05）。结论 HBV DNA高载量孕妇孕晚期服用替诺福韦可有效
阻断HBV母婴垂直传播且安全性较好。
|
|
Abstract: Objective To assess the efficacy and safety of tenofovir disoproxil (TDF) on blocking mother-to-
child transmission of HBV in pregnant women with HBV DNA high load in late pregnancy. Methods Total
of 200 pregnant women with high load of HBV DNA (HBV DNA ＞ 1.0 × 10 6 IU/ml) who were examined at
the mother and infant block clinic of Jilin Provincial Hepatobiliary Diseases Hospital and met the inclusion
and exclusion criteria from August 2014 to December 2016 were selected. The pregnant women were divided
into treatment group (128 cases) and control group (72 cases) according to the intervention methods. Patients
in treatment group were given TDF orally at the 28 th week of gestation until 4 weeks after delivery. Patients
in control group did not receive antivirals during pregnancy. All infants in both groups were vaccinated with
hepatitis B immunoglobulin and hepatitis B vaccine immediately after birth. The serum HBV DNA load of
patients in both groups were assayed at delivery and 12 weeks after delivery. The positive rates of HBsAg,
HBeAg and HBV DNA of infants at 28 weeks after birth were also detected. In addition, the gestation weeks,
length, head of circumference, weight and Apgar scores of all infants were also recorded. Results The serum
HBV DNA load of pregnant women in treatment group before delivery was (4.79 ± 0.89) IU/ml, which was
significantly lower than that in control group [(7.60 ± 0.73) IU/ml] and before treatment [(7.87 ± 0.51) IU/ml] (P
＜ 0.05). At the age of 28 weeks, the infection rate of HBV of infants in treatment group was 0.0%, which
was significantly lower than that in control group (5.6%) (χ 2 = 7.256, P = 0.007). In addition, there were
no significant differences in gestational age, body length, head circumference, body mass and Apgar score
between infants of two groups at birth (P ＜ 0.05). There were no significant difference in preterm birth,
postpartum herencemorrhage rate, cesaream section rate and serum creatine kinase (CK) of pregnant women
between the two groups (P ＜ 0.05). Conclusion TDF on blocking the mother-to-child transmission of HBV
in pregnant women with HBV DNA high load in late pregnancy is efficacy and safety.
|
|
基金项目：
|
|
|
|
作者简介：
|
|
|
|
参考文献：
|
|
|
|
服务与反馈：
|
|
【文章下载】【加入收藏】
|
|
|
|