替诺福韦酯治疗乙肝孕妇的疗效及对母婴HBV垂直传播的影响

Curative effect of tenofovir disoproxil in the treatment of hepatitis B pregnant women and its effect on the mother-infant vertical transmission of HBV

目的探讨乙肝孕妇服用替诺福韦酯疗效及其对阻断母婴乙型肝炎病毒(HBV)垂直传播的有效性。方法选取40例乙肝孕妇随机平均分为实验组和对照组,实验组于孕10周开始给予替诺福韦酯治疗,对照组采取常规保肝治疗,两组新生儿均采取阻断治疗。两组孕妇于孕12周、20周、30周对谷丙转氨酶(ALT)及HBV-DNA进行检测,统计ALT复常率及HBV-DNA的转阴率;新生儿1个月时进行乙肝五项测定,计算阻断成功率。结果孕12周,实验组ALT复常率和HBV-DNA转阴率分别为15%和10%,对照组为10%和10%,差异无统计学意义(P>0.05);孕20周,实验组ALT复常率和HBV-DNA转阴率为50%和45%,对照组为20%和15%,差异有统计学意义(P<0.05);孕30周,实验组ALT复常率和HBV-DNA转阴率为100%和95%,对照组为45%和40%,差异有统计学意义(P<0.05);实验组新生儿阻断成功率(100%)高于对照组(40%),差异有统计学意义(P<0.05)。结论对乙肝孕妇早期应用替诺福韦酯可以进行有效治疗,并能阻断母婴间HBV的垂直传播。

Objective To explore the efficacy of tenofovir dipivoxil in hepatitis B pregnant women and its effectiveness in blocking the mother-infant vertical transmission of hepatitis B virus （HBV）. Methods 40 pregnant women with hep- atitis B were selected and randomly divided into the experimental group and the control group. The experimental group was given tenofovir at 10 weeks of gestation, and the control group was given conventional liver protection. Both groups of newborns were given blockade therapy. Alanine aminotransferase（ALT） and HBV-DNA were detected at 12 weeks, 20 weeks, 30 weeks of gestation in both groups of pregnant women, and the ALT normalization rate and the negative conversion rate of HBV-DNA were calculated; The five-item hepatitis B examination was given to newborns at 1 months, and the success rate of blockade was calculated. Results At 12 weeks of gestation, the ALT normalization rate and HBV-DNA negative conversion rate were 15% and 10% respectively in the experimental group, and 10% and 10% respectively in the control group. The difference was not statistically significant（P〉0.05）; at 20 weeks of gestation, the ALT normalization rate and HBV-DNA negative conversion rate was 50% and 45% respectively in the experimental group, and 20% and 15% respectively in the control group. The difference was statistically significant（P〈0.05）; at 30 weeks of gestation, the ALT normalization rate and HBV-DNA negative conversion rate was 100% and 95% respectively in the experimental group, and 45% and 40% respectively in the control group. The difference was statistically signifi- cant （P〈0.05）; the success rate of neonatal blockade（100%） in the experimental group was higher than that in the con- trol group（40%）, and the difference was statistically significant （P〈0.05）. Conclusion The early application of tenofovir dipivoxil in hepatitis B pregnant women can effectively perform treatment and block the mother-infant vertical trans- mission of HBV.