替诺福韦联合苄星青霉素在阻断乙肝合并梅毒感染患者母婴传播中的效果

Effect of tenofovir combined with benzathine penicillin in blocking mother-to-child transmission of hepatitis B patients with syphilis infection

目的探讨替诺福韦联合苄星青霉素在阻断乙肝合并梅毒感染患者母婴传播中的效果。方法选取2016年1月至2018年1月百色市人民医院诊治的70例乙肝合并梅毒患者为研究对象,按照入院先后排序,单数序号患者设为研究组,双数序号患者设为对照组,每组35例患者。研究组患者给予替诺福韦联合苄星青霉素治疗,对照组患者给予常规保肝联合苄星青霉素治疗。在孕晚期对两组患者进行治疗后的效果评定。在分娩后对两组新生儿进行是否为先天性梅毒儿的检测和判定;在6个月时对两组婴儿检测HBsAg阳性表达率。结果对两组患者治疗后的效果显示,研究组患者梅毒治疗有效率(91.4%)高于对照组(88.6%),其差异无统计学意义(P>0.05);研究组患者乙肝治疗有效率(94.3%)高于对照组(80.0%),其差异具有统计学意义(P<0.05)。研究组正常新生儿比例(82.9%)高于对照组(51.4%),其差异具有统计学意义(P<0.05);研究组先天梅毒儿比例(8.6%)低于对照组(14.3%),其差异无统计学意义(P>0.05);研究组6个月婴儿HBsAg阳性率(5.7%)低于对照组(22.9%),其差异具有统计学意义(P<0.05)。结论替诺福韦联合苄星青霉素在阻断乙肝合并梅毒感染患者母婴传播中具有较好的治疗效果,值得临床推广。

Objective To explore the effect of tenofovir combined with benzathine penicillin in blocking mother-to-child transmission of hepatitis B patients with syphilis infection. Methods From January 2016 to January 2018, 70 pregnant women diagnosed as hepatitis B with syphilis in People′s Hospital of Baise were selected. According to the order of admission, patients at the singular number were the study group and the double number were the control group. The 35 patients in the study group were treated with tenofovir combined with benzathine penicillin, while the 35 patients in the control group were treated with routine hepatoprotection combined with benzathine penicillin. Evaluation of the treatment effect was performed in the third trimester of pregnancy. After delivery, the neonates were detected and judged whether they were congenital syphilis or not, and the positive expression rate of HBsAg was detected at 6 months. Results The effective rate of syphilis treatment in the study group(91.4%) was higher than that in the control group(88.6%), with no statistically significant difference(P>0.05);the effective rate of hepatitis B treatment in the study group(94.3%) was higher than that in the control group(80.0%) with statistically significant differences(P<0.05). The proportion of normal newborns in the study group(82.9%) was higher than that in the control group(51.4%) with statistically significant differences(P<0.05);the proportion of congenital syphilis infants in the study group(8.6%) was lower than that in the control group(14.3%), but there was no statistically significant difference(P>0.05);the HBsAg positive rate in the study group(5.7%) was lower than that in the control group(22.9%) at 6 months(P<0.05). Conclusions Tenofovir combined with benzathine penicillin has a good therapeutic effect in blocking mother-to-child transmission of hepatitis B patients with syphilis infection, which is worthy of clinical promotion.