替诺福韦酯和替比夫定阻断HBV母婴传播的疗效及安全性

Efficacy and safety of tenofovir disoproxil fumarate and telbivudine in blocking mother-to-child transmission of HBV

目的探讨替诺福韦酯(tenofovir disoproxil fumarate,TDF)和替比夫定(telbivudine,Ld T)阻断HBV母婴传播的疗效及安全性。方法选取2016年11月至2018年3月于邯郸市传染病医院接受治疗并分娩的HBV感染孕妇198例为研究对象,采用随机数字表法分为LdT组(99例)和TDF组(99例),LdT组孕妇采用替比夫定片进行抗病毒治疗,TDF组孕妇采用富马酸替诺福韦二吡呋酯片进行抗病毒治疗。观察治疗前后孕妇血清ALT和HBV DNA载量的变化、母婴传播阻断率及婴儿和孕妇的不良反应。结果治疗后两组孕妇血清ALT和HBV DNA较治疗前均显著降低,差异有统计学意义(P <0.05),治疗后,两组孕妇血清ALT和HBV DNA水平差异无统计学意义(P> 0.05)。两组婴儿7月龄时HBsAg均为阴性,母婴传播阻断率均为100%。两组婴儿分娩后的体质量、身长、Apgar评分及先天缺陷方面差异无统计学意义(P> 0.05)。结论乙型肝炎孕妇使用TDF或LdT抗病毒治疗均可降低HBV DNA载量,有效阻断母婴传播,且安全性较高。

Objective To investigate the efficacy and safety of tenofovir disoproxil fumarate(TDF)and telbivudine(LdT)in blocking mother-to-child transmission of HBV.Methods A total of 198 pregnant women with HBV infection who were treated and delivered in Handan Infectious Disease Hospital from November 2016 to March 2018 were selected and divided into LdT group(99 cases)and TDF group(99 cases)according to random number table.Patients in LdT group were given telbivudine tablets,and patients in TDF group were given tenofovir disoproxil fumarate tablets.The changes of serum ALT and HBV DNA of pregnant women were compared before and after treatment.The blocking rates of mother-to-child transmission and adverse reactions of infants and pregnant women were observed.Results After treatment,the serum ALT and HBV DNA of pregnant women in both groups were significantly lower than those before treatment(P<0.05).There were no significant differences in serum ALT and HBV DNA between the two groups after treatment(P>0.05).HBsAg of the infants were negative in both groups at the age of 7 months,and the blocking rates of mother-to-child transmission were both 100%.There were no significant differences in body mass,body length,Apgar score and birth defects between the infants of two groups(P>0.05).Conclusion TDF or LdT treatment for pregnant women with HBV infection can reduce HBV DNA load,and effectively block mother-to-child transmission,with high safety.