拉米夫定在阻断母婴传播慢性乙型肝炎中的临床观察

The clinical observation of effect of lumivudine on blocking mothertoinfant transmission of chronic HBV

目的 拉米夫定能有效地阻断母婴垂直传播乙型肝炎。方法 对87例HBSAg、HBeAg阳性的孕妇进行随机分组，分为治疗组（A）45例与对照组（B）42例，A组45例在妊娠24周口服拉米夫定100mg，每日1次至分娩后停药。B组42例孕妇在28周、32周、36周各肌肉注射100U乙肝免疫球蛋白。两组中所生的新生儿在分娩2小时肌肉注射乙肝免疫球蛋白100U，6小时接种重组酵母乙肝疫苗5μg，并且在分娩后1、6个月按时接种重组酵母乙肝疫苗5μg。结果 A组45例孕妇所生的1岁婴儿中外周血清检测1例HBSAg阳性。阻断率97．78％。B组42例孕妇所生的新生儿的1岁婴儿中外周血清检测6例HBSAg阳性，阻断率85．71％。结论 A组阻断率明显高于B组，拉米夫定能降低母婴传播乙型肝炎的风险。

Objective To evaluate the blocking effect of lumivuding on blocking mothertoinfant transmission of chronic HBV. Methods the 87 pregnant women with HBsAg and HBeAa positive were divided into treatment group A （n=45） and control group B （n = 42） randomly, Each pregnant woman in Group A （n = 45） should take lOOmg lumivudine per day from 24th week of gestation to delivery, while each pregnant woman in deliver Group B （n=42） was injected intramuscularly with hepatitis B immunoglobulin（HBIG） 100 u each in the 28th, 32nd and 36th week of gestation, And each of their infants was injected intramuscularly with HBIG 100U 2 hours after birth and then with 5 doses of recombinant yeastderived hepatitis B vaccine each on 6 hours, 1 month and 6 month after birth routinely. Results There is only one HBsAg positivive infant of one year old in Group A （n=45） and 6 ones in Group B （n=42）,The blocking rate is 97,78% and 85.71% respectively, Conclusion The blocking rate of Group A is obviously higher than Group B. The lumivudine can improve the blocking of mothertoinfant transmission of HBV.