拉米夫定阻断乙型肝炎病毒宫内感染的临床研究

Clinical research on lamivudine blocking HBV intrauterine infection

目的探讨拉米夫定用于阻断乙型肝炎病毒宫内感染的临床效果,寻找阻断乙型肝炎病毒宫内感染的更优方法。方法选取2011年6-11月医院收治携带乙型肝炎病毒的孕妇83例与同期分娩的产妇77例分为观察组和对照组,对照组产妇实施单纯乙型肝炎免疫球蛋白(HBIG)肌内注射,观察组孕妇在对照组基础上给予拉米夫定口服;对两组孕妇肝功能、HBV-DNA水平以及新生儿HBV-M检测结果进行评价,数据采用SPSS13.0软件进行分析。结果观察组孕妇在孕4个月及临产前肝功能差异无统计学意义;观察组孕妇在孕中和临产前HBVDNA滴度明显低于对照组;观察组新生儿抗HBc和抗HBe阳性者均明显低于对照组,两组比较差异有统计学意义(P<0.05)。结论拉米夫定阻断乙型肝炎病毒宫内感染是一种安全而有效的方法,在临床进行推广应用可以明显降低乙型肝炎病毒的宫内感染率。

OBJECTIVE To investigate clinical results of lamivudine for blocking the hepatitis B virus（HBV）intrauterine infection,and look for a better way to block HBV intrauterine infection.METHODS Totally 83 pregnant women carrying HBV admitted in our hospital in Jul.to Nov.2011 were taken as the observation group and 77 pregnant women giving birth over the same period as the control group.The control group received single intramuscular injection of HBIG,while the observation group was received oral lamivudine in addition to HBIG.Liver function,HBV-DNA levels and neonatal HBVM detection were evaluated for the two groups of pregnant women.RESULTS There were no significant differences in liver function for the observation group at four months of pregnancy and before labor.HBV-DNA titers were significantly lower in the observation group than in the control group during pregnancy and before labor.There were much less anti-HBc and anti-HBe positive neonates in the observation group than in the control group,the difference was significant（P0.05）.CONCLUSION Lamivudine blocking HBV intrauterine infection is a safe and effective method to promote the clinical application which can significantly reduce HBV intrauterine infection.