替比夫定联合乙肝免疫球蛋白阻断HBV母婴传播疗效研究

New research for efficacy of telbivudine blocking HBV transmission from mother to child

目的 探讨替比夫定阻断HBV母婴垂直传播的疗效.方法 收集2007年11月至2009年6月在杭州市第六人民医院就诊的64例孕妇,将其分为对照组（36例）和治疗组（28例）,2组孕妇在妊娠第28、32和36周均肌注HBIG 200IU各1次,治疗组孕妇在孕28周时同时口服替比夫定,600 mg/d,观察2组新生儿HBV DNA载量和HB8Ag水平.结果 对照组所生新生儿HBsAg阳性率为30.56%（11/36）,治疗组所生新生儿HBsAg阳性率为7.14%（2/28）,2组相比差异有统计学意义（χ^2=3.985,P=0.046）,对照组所生新生儿HBV DNA阳性率为16.67%（6/36）,治疗组所生新生儿HBV DNA阳性率为0,2组比较差异具有统计学意义（P＜0.05）.所有孕妇及新生儿在治疗期间未出现不良反应.结论 替比夫定在一定程度上可以降低HBV母婴垂直传播的风险.

Objective To investigate the efficacy of telbivudine blocking the spread of hepatitis B virus in intrauterine. Methods Collecting 64 cases of pregnant women who receive treatment in Hangzhou Sixth People＇s hospital between November 2007-June 2009,which are divided into control group （36 cases）and treatment group （28 eases）. Two groups of pregnant women intramuscular HBIG 200IU each one times during pregnancy 28, 32 and 36 weeks. Pregnant women of treatment simultaneously oral telbivudine tabels,600 mg/d. To observe the HBV DNA load and HBsAg levels in newborns of two groups. Results HBsAgpositive rate is 30.56% （11/36） in newborns of the treatment group, which is 7. 14% （2/28） in control group. The difference is statistically significant between two groups （ χ^2 = 3. 985, P = 0. 046 ）. HBV DNA positive rate is 1 16.67% （6/36） in newborns of control group, which is 0 in treatment group. The difference is statistically significant between two groups （ P 〈 0.05 ）. All pregnant women and newborns do not appear adverse reactions during the treatment. Conclusion HBV blocking rate of treatment group is significantly higher than control group. The results suggest that telbivudine can reduce the risk of HBV vertical transmission to a certain extent.