拉米夫定阻断乙肝病毒宫内感染分娩后不同停药时间对妊娠妇女的影响分析

Influence of Different Stopping Time on Pregnant Women after Interruption of Hepatitis B Virus Intrauterine Infection by Lamivudine

目的:探讨分析拉米夫定阻断乙肝病毒宫内感染分娩后不同停药时间对妊娠妇女的影响。方法:选取本院2015年6月—2016年6月期间收治的乙肝病毒宫内感染孕妇80例,并随机分为观察组60例和对照组20例,对照组患者不给予药物治疗,观察组患者给予拉米夫定治疗,根据停药时间不同又将观察组患者分为1组、2组和3组,对两组患者用药情况进行对比分析。结果:观察组分娩前HBV-DNA定量与对照组相比显著要低(P<0.05);观察组患者在停药1个月后HBV-DNA定量均恢复到治疗前的水平;1组停药后1个月、3个月及6个月肝功能总异常率最低,显著低于其他3组(P<0.05),而对照组又明显高于其他3组(P<0.05),2组与3组之间对比无明显差异(P>0.05);观察组新生儿宫内感染率显著低于对照组(P<0.05)。结论:拉米夫定对阻断乙肝病毒宫内感染效果确切,高病毒载量的孕妇可在分娩之后即停药,不过需要注意停药之后定期对肝功能及HBV-DNA定量进行检测。

Objective To investigate the effect of different stopping time of lamivudine on intrauterine pregnancy after interruption of hepatitis B virusintrauterine infection. Methods：80 cases of hepatitis B virus intrauterine infection in our hospital during June 2015～June 2016 were selected, andrandomly divided into observation group of 60 cases and control group of 20 cases. Patients in the control group were not given medication. Patientsin the observation group were treated with lamivudine. According to different drug withdrawal time, the patients in the observation group weredivided into group 1, 2 and 3. The two groups of patients with medication were analyzed. Results： The HBV-DNA of the observation group beforedelivery was significantly lower than that of the control group （P〈0.05）;The HBV-DNA of the observation group returned to the level before treatment1 months after the withdrawal; The total abnormal rate of liver function was the lowest in the 1 groups after 1 months, 3 months and 6 months,which was significantly lower than the other 3 groups （P〈0.05）. The control group was significantly higher than the other 3 groups （P〈0.05）. Therewas no significant difference between the 2 groups and the 3 groups （P〉0.05）. The neonatal intrauterine infection rate in the observation group wassignificantly lower than that in the control group （P〈0.05）. Conclusion： Lamivudine is effective in blocking intrauterine infection of hepatitis B virus.Pregnant women with high viral load can stop the drug after delivery. However, the liver function and HBV-DNA quantitation should be examinedregularly after withdrawal.