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| 合并HBV感染孕妇口服替诺福韦对母婴传播阻断效果及安全性研究 |
| Safety of oral tenofovir and efficacy on the prevention of mother-to-child transmission in pregnant women with HBV infection |
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| DOI：10.3969/j.issn.1007-8134.2019.06.012 |
| 中文关键词: 乙型肝炎病毒感染 孕妇 替诺福韦 母婴传播阻断 不良反应 安全性 |
| 英文关键词: HBV infection pregnant women tenofovir prevent mother-to-child transmission adverse reactions security |
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| 中文摘要: |
| 目的 探讨合并HBV感染孕妇口服替诺福韦对母婴传播阻断效果及安全性研究。方法 选取2014年1月—2018年10月来我院就诊的80例合并HBV感染的孕妇作为研究对象，采用随机数字表法将其分为观察组（n=40）和对照组（n=40）。观察组给予口服替诺福韦至分娩，对照组给予口服替比夫定至分娩。2组新生儿出生后均给予标准免疫预防（乙型肝炎人免疫球蛋白100 IU+乙型肝炎疫苗），对比2组孕妇血清HBV DNA、ALT及CRE水平，HBV母婴传播阻断效果，产后出血量、产后出血率、不良反应发生率。结果 分娩前，观察组HBV DNA及ALT水平均明显低于对照组[（2.87±0.37）×106 IU/ml vs.（4.27±0.51）×106 IU/ml、（27.03±3.41）U/L vs.（45.21±5.18）U/L]，同时CRE水平明显高于对照组[（266.38±31.34）mg/L vs.（183.93±22.45）mg/L]（P均＜0.05）；观察组母婴阻断成功率明显高于对照组（100% vs. 87.5%）（P＜0.05）；观察组产后出血量明显低于对照组[（421.42±49.28）ml vs.（493.17±51.04）ml]，同时观察组产后出血率及不良反应发生率均明显低于对照组（P均＜0.05）。结论 口服替诺福韦对合并HBV感染的孕妇可有效降低血清HBV DNA、ALT水平，提高CRE水平，母婴阻断成功率高，安全性好，在临床上值得推广及应用。 |
| 英文摘要: |
| Objective To explore the safety of oral tenofovir and efficacy of preventing mother-to-child transmission in pregnant women with hepatitis B infection. Methods Eighty pregnant women with hepatitis B virus infection admitted to our hospital from January 2014 to October 2018 were included in this study, and they were divided into observation group (n=40) and control group (n=40) according to random number table method. In the observation group, the patients were given oral tenofovir until delivery, while the patients in the control group were given oral telbivudine until delivery. The newborns in 2 groups received standard immunoprophylaxis (hepatitis B human immune globulin 200 IU + hepatitis B vaccine). Serum levels of HBV DNA, alanine aminotransferase (ALT) and creatinine (CRE), effect of preventing HBV mother-to-child transmission, postpartum blood loss, incidence of postpartum hemorrhage rate and adverse reactions were compared between 2 groups. Results Before delivery, HBV DNA and ALT levels in the observation group were significantly lower than those in the control group [(2.87±0.37)×106 IU/ml vs. (4.27±0.51)×106 IU/ml, (27.03±3.41) U/L vs. (45.21±5.18) U/L], and CRE levels were significantly higher than those in the control group [(266.38±31.34) mg/L vs. (183.93±22.45) mg/L] (P＜0.05). The success rate of preventing mother-to-child transmission in the observation group was significantly higher than that in the control group (100% vs. 87.5%) (P＜0.05). The amount of postpartum blood loss in the observation group was significantly lower than that in the control group [(421.42±49.28) ml vs. (493.17±51.04) ml], and the incidence of postpartum hemorrhage and adverse reactions in the observation group was significantly lower than that in the control group (P＜0.05). Conclusions Oral administration of tenofovir can effectively reduce serum HBV DNA and ALT levels, elevate CRE level in pregnant women combined with HBV infection, improve success rate of preventing mother-to-child transmission. It is a safe approach and worthy of promotion and application in clinical practice. |
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