替比夫定对乙型肝炎E抗原阳性慢性乙肝孕妇血清辅助性T细胞和乙肝病毒基因载量的影响

Effect of telbivudine on serum Th factor and HBV DNA load in HBeAg-positive chronic hepatitis B pregnant women

目的观察替比夫定治疗前后乙型肝炎E抗原(HBeAg)阳性慢性乙型肝炎(CHB)患者血清辅助性T细胞(Th)和乙肝病毒基因(HBV DNA)载量的变化,分析替比夫定对于CHB母婴传播的影响。方法选取2013年8月-2015年7月医院接受替比夫定治疗的HBeAg阳性CHB孕妇92例为观察组,将仅接受保肝治疗的HBeAg阳性CHB孕妇92例为对照组,对比分析孕妇血清Th因子和HBV-DNA载量变化,比较新生儿出生时HBV DNA载量和乙肝抗原抗体阳性情况。结果治疗后,观察组孕妇血清INF-γ和IL-2显著高于对照组(P<0.05),而IL-4、IL-6、HBV DNA阳性率、HBV DNA载量显著低于对照组(P<0.05);观察组新生儿HBeAg阳性率、HBV DNA阳性率显著低于对照组(P<0.05)。结论替比夫定能够改善HBeAg阳性CHB孕妇血清Th因子表达水平,降低HBV DNA载量,对于阻断CHB母婴垂直传播具有重要意义。

OBJECTIVE To observe the changes of serum Th and HBV DNA load in HBeAg-positive patients with chronic hepatitis B（CHB）before and after telbivudine therapy,and analyze the influence of telbivudine on motherto-child transmission of CHB.METHODS A total of 92HBeAg-positive CHB pregnant women treated with telbivudine in our hospital from Aug.2013 to Jul.2015 were retrospectively chosen as observation group,and another92HBeAg-positive CHB pregnant women received hepatoprotective therapy were selected as control group.The changes of serum Th factor and HBV DNA load of pregnant women were compared.The HBV DNA load and hepatitis B antigen antibody positive situations of the newborns were compared.RESULTS After treatment,the serum INF-γand IL-2in observation group were significantly higher than those in control group（P〈0.05）,while IL-4,IL-6,HBV DNA positive rate,and HBV DNA load were significantly lower than those of control group（P〈0.05）.The positive rate of HBeAg and HBV DNA load positive rate of newborns in observation group were significantly lower than those in control group（P〈0.05）.CONCLUSIONTelbivudine can improve the expression of serum Th factor in HBeAg-positive CHB pregnant women and reduce HBV DNA load,which is important for blocking the vertical transmission of CHB mother and child.