母婴阻断在乙型肝炎孕妇中的应用效果及对纯母乳喂养率和乙肝病毒载量的影响

Effect of blockade of mother to child transmission of hepatitis B on pregnant women with hepatitis B and its effect on exclusive breastfeeding rate and hepatitis B virus load

目的探讨母婴阻断在乙型肝炎孕妇中的应用效果及对纯母乳喂养率、乙肝病毒载量的影响。方法选择东营市东营区人民医院2015年3月至2018年3月治疗的乙型肝炎孕妇82例,使用数字随机法分为对照组和观察组各41例,对照组接受替比夫定阻断治疗,观察组接受替比夫定联合拉米夫定阻断治疗。比较两组孕妇阻断后的纯母乳喂养率进而乙肝感染率、不良反应发生率、阻断前后的乙肝病毒载量。结果观察组孕妇的阻断后的纯母乳喂养率高于对照组(χ^(2)=8.467,P=0.031),HBsAg转阳率、HBV感染慢性化率和HBV-DNA阳性率均低于对照组(χ^(2)=7.943、6.581、5.387,P=0.036、0.039、0.041),阻断后观察组孕妇的HBV-DNA病毒载量、HBsAg和HBeAg定量均低于对照组(t=8.646、5.491、9.667,P<0.001);阻断后观察组孕妇的恶心呕吐、腹泻、皮疹、早产和低体重儿不良反应发生率低于对照组(χ^(2)=8.654,P=0.041)。结论替比夫定联合拉米夫定阻断能够有效减少新生儿的乙肝感染率、乙肝病毒载量和阻断不良反应发生率。

Objective To explore the effect of blockade of mother-to-child transmission of hepatitis B virus(HBV)in pregnant women with HBV and its influence on exclusive breastfeeding rate and HBV load.Methods A total of 82 pregnant women with hepatitis B infection who were treated from March 2015 to March 2018 in Dongying District People’s Hospital of Dongying city were enrolled.They were randomly divided into control group and observation group with 41 cases in each.The control group received telbivudine treatment for blokcade.The observation group received telbivudine combined with lamivudine blockade therapy.The rate of exclusive breastfeeding,the rate of hepatitis B infection,the rate of good response,and the hepatitis B viral load before and after the blockade were compared between the two groups of pregnant women.Results The rate of exclusive breastfeeding of pregnant women in the observation group was higher than that of the control group(χ^(2)=8.467,P=0.031),and the rate of HBsAg conversion,the chronicity rate of HBV infection and the positive rate of HBV-DNA were lower than those of the control group(χ^(2)=8.467,P=0.031).χ^(2)=7.943,6.581,5.387,P=0.036,0.039,0.041,the result of HBV-DNA viral load,HBsAg and HBeAg quantitative determinations of pregnant women in the observation group after blocking were lower than those in the control group(t=8.646,5.491,9.667,P=0.000);The incidence of nausea,vomiting,diarrhea,rash,premature birth and low birth weight infants in the observation group was lower than those in the control group(χ^(2)=8.654,P=0.041).Conclusions Telbivudine combined with lamivudine block can effectively reduce the rate of hepatitis B virus transmission from mothers to their infants,hepatitis B virus load and the incidence of adverse reactions in newborns.