替诺福韦阻断HBV母婴传播的疗效及对母婴安全性的影响

Efficacy of tenofovir in blocking mother-to-child transmission of HBV and its impact on mother-to-child safety

目的观察替诺福韦阻断乙型肝炎病毒(HBV)母婴传播的疗效及对母婴安全性的影响。方法 100例HBV高载量妊娠晚期孕妇,根据所接受的治疗手段不同分为观察组和对照组,每组50例。观察组于孕24周开始给予替诺福韦治疗至分娩,对照组仅接受保肝治疗,两组新生儿均采取阻断治疗。比较两组孕妇的治疗效果[乙型肝炎病毒脱氧核糖核酸(HBV-DNA)载量、乙型肝炎核心抗体(HBcAb)与乙型肝炎e抗原(HBeAg)定量水平],新生儿阻断成功率,孕妇的不良反应发生情况。结果孕24周时,两组孕妇的HBV-DNA载量, HBcAb、HBeAg定量比较,差异无统计学意义(P>0.05);观察组孕妇分娩前的HBV-DNA载量、HBeAg定量低于孕24周,差异有统计学意义(P<0.01), HBcAb定量与孕24周比较,差异无统计学意义(P>0.05);对照组孕妇分娩前的HBV-DNA载量, HBcAb、HBeAg定量与孕24周比较,差异均无统计学意义(P>0.05)。观察组新生儿阻断成功率为100.00%(50/50),与对照组的98.0%(49/50)比较,差异无统计学意义(χ^(2)=1.010, P>0.05)。观察组不良反应发生率为4.0%,与对照组的10.0%比较,差异无统计学意义(χ^(2)=1.382, P>0.05)。结论替诺福韦阻断HBV母婴传播的效果显著,安全性高,值得临床推广应用。

Objective To observe the efficacy of tenofovir in blocking mother-to-child transmission of hepatitis B virus(HBV)and its impact on mother-to-child safety.Methods A total of 100 cases of late pregnant women with high-load HBV were divided into observation group and control group according to different treatment methods,with 50 cases in each group.The observation group received tenofovir treatment at 24 weeks of gestation until delivery,and the control group received liver protection therapy only.Newborns in the two groups received blocking therapy.The therapeutic effect[hepatitis B virus deoxyribonucleic acid(HBV-DNA)load,hepatitis B core antibody(HBcAb)and hepatitis B e antigen(HBeAg)quantification],success rate of neonatal block,and incidence of adverse reactions in pregnant women were compared between the two groups.Results At 24 weeks of gestation,there was no statistically significant difference in HBV-DNA load,HBcAb,HBeAg quantification between the two groups(P>0.05).The HBV-DNA load,HBcAb,HBeAg quantification before delivery of the observation group were lower than those at 24 weeks of gestation,and the difference was statistically significant(P<0.01).There was no statistically significant difference in HBcAb quantification compared with those at 24 weeks of gestation(P>0.05).In the control group,there was no statistically significant difference in HBV-DNA load,HBcAb,HBeAg quantification before delivery and 24 weeks of gestation(P>0.05).The success rate of neonatal block of the observation group was 100.00%(5/50),which had no statistically significant difference compared with 98.0%(49/50)of the control group(χ^(2)=1.010,P>0.05).The incidence of adverse reactions of the observation group was 4.0%,which had no statistically significant difference compared with 10.0%of the control group(χ^(2)=1.382,P>0.05).Conclusion Tenofovir has remarkable effect in blocking mother-to-child transmission of HBV with high safety,and it is worthy of clinical promotion and application.