替比夫定应用于妊娠晚期孕妇慢性乙型肝炎的疗效以及不良反应研究

Study on the Efficacy and Adverse Reactions of Telbivudine in Pregnant Women with Chronic Hepatitis B in the Third Trimester of Pregnancy

目的评估慢性乙型肝炎妊娠晚期孕妇应用替比夫定治疗的效果以及产生的不良反应。方法选择医院2020年3月—2021年3月期间就诊的慢性乙型肝炎妊娠晚期孕妇100例,根据随机数表法进行分组,对照组(n=50)给予常规治疗(肌肉注射免疫球蛋白+注射乙肝疫苗治疗),观察组(n=50)在常规治疗之上采用替比夫定治疗,将两组慢性乙型肝炎妊娠晚期孕妇的治疗效果以及产生的不良反应予以比较。结果观察组治疗3周与治疗6周的不良反应发生率(4.00%、8.00%)与对照组(6.00%、6.00%)相比,差异无统计学意义(χ^(2)=0.211、0.154,P>0.05)。观察组治疗3周后的(轻度乙型肝炎、中度乙型肝炎、重度乙型肝炎)患者ALT改善率(76.19%、75.00%、70.59%)均高于对照组(43.48%、33.33%、33.33%),差异有统计学意义(χ^(2)=4.859、4.199、4.441,P<0.05)。治疗6周后,观察组轻度乙型肝炎孕妇的ALT改善率(100.00%)高于对照组(73.91%),差异有统计学意义(χ^(2)=6.343,P<0.05);观察组中度乙型肝炎(91.67%)、重度乙型肝炎ALT改善率(100.00%)高于对照组(58.33%、86.67%),但是两组中度乙型肝炎、重度乙型肝炎ALT改善率相比,差异无统计学意义(χ^(2)=3.556、2.418,P>0.05)。结论慢性乙型肝炎妊娠晚期孕妇采用替比夫定治疗的疗效显著,不良反应较低,值得在临床中予以推广使用。

Objective To evaluate the effects of telbivudine treatment and adverse reactions in pregnant women with chronic hepatitis B in the third trimester of pregnancy.Methods A total of 100 pregnant women with chronic hepatitis B in late pregnancy who were treated in the hospital from March 2020 to March 2021 were selected.According to the random number table method,the control group(n=50)was given conventional treatment(intramuscular injection of immunoglobulin+hepatitis B vaccine treatment),and the observation group(n=50)was treated with telbivudine on top of the conventional treatment.The therapeutic effects and adverse reactions of the two groups of pregnant women with chronic hepatitis B in late pregnancy were compared.Results There was no statistically significant difference in the incidence of adverse reactions between the observation group(4.00%,8.00%)and the control group(6.00%,6.00%)for three weeks of treatment and six weeks of treatment(χ^(2)=0.211,0.154,P>0.05).The ALT improvement rate of patients in the observation group(mild hepatitis B,moderate hepatitis B,severe hepatitis B)after three weeks of treatment(76.19%,75.00%,70.59%)all higher than the control group(43.48%,33.33%,33.33%),the difference was statistically significant(χ^(2)=4.859,4.199,4.441,P<0.05).After six weeks of treatment,the ALT improvement rate of pregnant women with mild hepatitis B in the observation group(100.00%)was higher than that of the control group(73.91%),the difference was statistically significant(χ^(2)=6.343,P<0.05);the ALT improvement rate of the observation group with moderate hepatitis B(91.67%)and severe hepatitis B(100.00%)was higher than that of the control group(58.33%,86.67%),however,the difference was not statistically significant(χ^(2)=3.556,2.418,P>0.05).Conclusion Telbivudine treatment for pregnant women with chronic hepatitis B in the third trimester has a significant effect and low side effects.It is worthy of clinical application.