替比夫定阻断妊娠期慢性乙型肝炎宫内传播相关研究

Clinical studies on telbivudine blocking effect of mother-to-infant transformation of pregnant women with chronic hepatitis B virus

目的探讨乙肝患者妊娠3个月服用替比夫定后阻断乙型肝炎病毒宫内传播的疗效及其安全性分析。方法选取80例乙肝妊娠患者,随机分为实验组和对照组,每组40例。实验组于12周开始口服替比夫定片,持续至产后6个月,对照组不给予抗病毒药物治疗,分析两组患者HBV DNA和HBs Ag变化情况及新生儿出生后的感染率。结果实验组患者于6个月、9个月、分娩时及产后6个月检测HBV DNA呈阴性,与对照组比较,差异有统计学意义(P<0.05);实验组新生儿于出生时、3个月、6个月检测HBV感染率均为0,疗效显著好于对照组,差异有统计学意义(P<0.05);两组新生儿Apgar评分及基本生理指标比较差异无统计学意义。结论乙肝患者于妊娠3个月开始服用替比夫定后不仅能阻断乙肝病毒宫内传播,且对孕妇起到一定的保护作用,值得在临床进一步推广。

Objective To evaluate the efficacy of telbivudine(LDT)in blocking mother-to-child hepatitis B virus(HBV)transmission and its safety analysis early pregnancy in human.Methods 80 cases of pregnant women with chronic hepatitis B virus were divided into experimental group and control group,40 cases in each group.Pregnant women in the experimental group were treated with telbivudine 600 mg/d since 12 weeks and lasting for half a year,while the pregnant women in the control group did not take any antiviral drugs,then comparing the HBV-DNA and HBsAg negative transformation rate and the infection rate of newborns.Results The HBV-DNA levels were descended of pregnant women with chronic hepatitis B virus after treated with telbivudine,the values of the descending of the treatment group was significantly lower than the control group(P<0.05).In the experimental group,HBV DNA was negative at 6 months,9 months,childbirth and 6 months postpartum,there was a statistically significant difference between the two groups(P<0.05).In the experimental group,the HBV infection rate was 0 at 3 months and 6 months,and the curative effect was significantly better than that of the control group(P<0.05).There were no significant differences in Apgar scores and basic physiological indexes between the two groups.Conclusion Telbivudine is not only effective in block mother-to-infant transformation but also treatment of pregnant women for three months with chronic hepatitis B virus,which was safer and will be widely applied in clinical.