替诺福韦治疗乙型肝炎病毒高载量妊娠晚期孕妇的临床疗效及其安全性

Clinical efficacy and safety of tenofovir for late pregnant women with high hepatitis B virus load

目的探讨替诺福韦治疗乙型肝炎病毒高载量妊娠晚期孕妇的临床疗效及其安全性。方法选取资中县人民医院2016年6月—2017年10月收治的乙型肝炎病毒高载量妊娠晚期孕妇96例,根据治疗方式分为对照组和观察组,各48例。对照组孕妇进行常规干预,观察组孕妇在常规干预基础上给予替诺福韦治疗。比较两组孕妇治疗前、治疗后4周、分娩时血清乙型肝炎病毒(HBV)DNA及丙氨酸氨基转移酶(ALT)水平,新生儿出生时及出生后3、6个月HBV DNA阳性率及乙型肝炎表面抗原(HBsAg)阳性率,并观察两组孕妇不良反应发生情况。结果治疗前两组孕妇血清HBV DNA及ALT水平比较,差异无统计学意义(P>0.05);治疗后4周、分娩时观察组孕妇血清HBV DNA及ALT水平低于对照组(P<0.05)。观察组新生儿出生时,出生后3、6个月HBV DNA阳性率及HBsAg阳性率低于对照组(P<0.05)。两组孕妇不良反应发生率比较,差异无统计学意义(P>0.05)。结论替诺福韦治疗乙型肝炎病毒高载量妊娠晚期孕妇的临床疗效确切,可降低乙型肝炎病毒对孕妇及新生儿的影响,且安全性较高。

Objective To investigate the clinical efficacy and safety of tenofovir for late pregnant women with high hepatitis B virus load.Methods A total of 96 cases of pregnant women with high hepatitis B virus load in third trimester of pregnancy were selected from June 2016 to October 2017 in Zizhong People’s Hospital,which were divided into control group and observation group according to the treatment method,48 cases in each group.The control group was given routine intervention,while the observation group was given tenofovir based on the routine intervention.The levels of serum HBV DNA and ALT were compared before treatment,4 weeks after treatment,and at delivery.The positive rates of HBV DNA and HBsAg at birth and 3 and 6 months after birth were compared.The adverse reactions of pregnant women in the two groups were observed.Results There was no significant differences in serum HBV DNA or ALT levels between the two groups before treatment(P>0.05);the observation group of the serum HBV DNA and ALT levels were lower than the control group at 4 weeks after treatment and at delivery(P<0.05).At birth,3 and 6 months after birth the observation group of the positive rate of HBV DNA and HBsAg were lower than the control group(P<0.05).There was no significant difference in the incidence rate of adverse reactions between the two groups(P>0.05).Conclusion Tenofovir is effective for late pregnant women with high hepatitis B virus load,it can reduce the impact of hepatitis B virus on pregnant women and newborns,and with high safety.