妊娠晚期应用替比夫定阻断乙型肝炎病毒宫内感染的疗效

Efficacy of telbivudine on blocking intrauterine infection of hepatitis B virus in late pregnancy

目的探讨妊娠晚期应用替比夫定阻断乙型肝炎病毒母婴传播的临床疗效及安全性。方法选取2012年3月至2015年6月于邯郸市传染病医院治疗的慢性乙型肝炎妊娠晚期孕妇200例,按照入院时间分为试验组和对照组,每组100例。对照组患者采用常规治疗,试验组在对照组的基础上加用替比夫定,孕26周开始,600 mg,1次/天至分娩。分别比较治疗3周和6周后两组不同肝脏炎症程度患者的临床症状、ALT改善及不良反应。结果治疗3周和6周时,两组患者临床症状改善差异无统计学意义(P均>0.05)。治疗3周后,试验组和对照组中轻度乙型肝炎患者ALT改善率分别为86.7%和59.5%,差异有统计学意义(χ~2=4.036,P=0.040),治疗3周和6周时,两组中度和重度乙型肝炎患者ALT改善率差异均无统计学意义(P均>0.05)。两组患者均无严重不良反应,不良反应发生率差异无统计学意义(χ~2=1.85,P=0.45)。结论替比夫定在阻断妊娠晚期轻度乙型肝炎孕妇的母婴传播方面具有一定效果。

Objective To investigate the clinical effcacy and safety of telbivudine on the prevention of mother-to-child transmission of hepatitis B virus in late pregnancy. Methods Total of 200 cases with chronic hepatitis B （CHB） in late pregnancy in Handan Infectious Disease Hospital from March 2012 to June 2015 were enrolled and divided into experimental group and control group according to the time of admission, 100 cases in each group. Patients in control group were given conventional treatment and patients in experimental group were given telbivudine （600 mg, one time per day） on the basis of control group. After treated for 3 weeks and 6 weeks, the clinlcal symptom, development of ALT and adverse reactions in patients with different degree of Hepatitis B between the two groups were compared. Results After 3 weeks and 6 weeks of treatment, there were no signifcant differences in clinical symptoms between the two groups （P 〉 0.05）. After 3 weeks of trial, the improvement rate of ALT in patients with mild hepatitis B in experimental group and control group were 86.7% and 59.5%, respectively, the difference was statistically signifcant （χ2 = 4.036,P = 0.040）. The improvement rate of ALT in patients with moderate and severe hepatitis B between experimental group and control group had no signifcant differences after treated for 3 weeks and 6 weeks （P 〉 0.05）. There were no serious adverse reactions in both groups, the difference had no statistical signifcance （χ2 = 1.85, P = 0.45）. Conclusion Telbivudine had a certain effect on blocking the mother-to-child transmission in patients with mild hepatitis B in late pregnancy.