替比夫定联合促肝细胞生长素治疗妊娠早期慢性乙型肝炎的疗效观察

Clinical observation of telbivudine combined with hepatocyte growth-promoting factors in treatment of chronic hepatitis B in early pregnancy

目的探讨替比夫定联合促肝细胞生长素治疗妊娠早期慢性乙型肝炎的临床。方法选取2013年1月—2015年6月在邯郸市传染病医院接受治疗的妊娠早期慢性乙型肝炎患者83例,随机分为对照组(42例)和治疗组(41例)。对照组静脉滴注促肝细胞生长素注射液,120μg加入到10%葡萄糖溶液200 m L中,1次/d。治疗组在对照组基础上睡前口服替比夫定片,600 mg/次,1次/d。两组患者均治疗8周。观察两组的临床疗效,比较两组乙型肝炎病毒脱氧核糖核酸(HBV-DNA)、丙氨酸转氨酶(ALT)、天氨酸转氨酶(AST)和婴儿乙肝表面抗体(抗-HBs)的水平。结果治疗4、8周后,对照组轻度患者有效率分别为52.63%、68.42%;治疗组轻度患者有效率分别为85.00%、100.00%,两组有效率比较差异有统计学意义(P<0.05)。治疗4周后,对照组ALT水平明显下降,而治疗组HBV-DNA、ALT和AST水平均明显下降,同组治疗前后比较差异有统计学意义(P<0.05);且治疗组这些观察指标的降低程度明显优于对照组,两组比较差异具有统计学意义(P<0.05)。随访后,对照组和治疗组婴儿抗-HBs阳性率分别为59.52%、80.49%,两组比较差异有统计学意义(P<0.05)。结论替比夫定联合促肝细胞生长素治疗妊娠早期慢性乙型肝炎具有较好的临床疗效,可阻断乙型肝炎病毒(HBV)母婴传播,安全性较好,具有一定的临床推广应用价值。

Objective To investigate the clinical effect of telbivudine combined with hepatocyte growth-promoting factors in treatment of chronic hepatitis B in early pregnancy. Methods Patients（83 cases） with chronic hepatitis B in early pregnancy in Handan Infectious Disease Hospital from January 2013 to June 2015 were randomly divided into the control group（42 cases） and the treatment group（41 cases）. Patients in the control group were iv administered with Hepatocyte Growth-Promoting Factors Injection, 120 μg added into 10% glucose solution 200 m L, once daily. Patients in the treatment group were po administered with Telbivudine Tablets on the basis of the control group, 600 mg/time, once daily. Patients in two groups were treated for 8 weeks. After treatment, the clinical efficacies were evaluated, and the levels of HBV-DNA, ALT, AST, and HBs Ab in two groups were compared. Results After treatment for 4 and 8 weeks, the clinical efficacies of mild patients in the control group were 52.63% and 68.42%, respectively, but the clinical efficacies of mild patients in the treatment group were 85.00% and 100.00%, respectively, and there was difference between two groups（P〈0.05）. After treatment for 4 weeks, the level of ALT in the control group was significantly decreased, but the levels of HBV-DNA, ALT, and AST in the treatment groups were significantly decreased, and the difference was statistically significant in the same group（P〈0.05）. And the observational indexes in the treatment group were significantly better than those in the control group, with significant difference between two groups（P〈0.05）. After follow-up, the positive rate of infant HBs Ab in the control and treatment groups were 59.52% and 80.49%, respectively, and there was difference between two groups（P〈0.05）. Conclusion Telbivudine combined with hepatocyte growth-promoting factors has clinical curative effect in treatment of chronic hepatitis B in early pregnancy, and can block the mother to child transmission of HBV, with good safety, which has a certain clinical application value.