替比夫定阻断乙型肝炎病毒宫内感染效果和安全性研究  

The efficacy and safety of telbivudine in blocking intrauterine hepatitis B viral transmission

作　　者：姚展成[1] 陈明纯[1] 廖文燕[1] 张艳萍[1] 吴毅[1] 李丽燕[1] 冯晶[1] 林美珊[1] 陈楚昂[1] 郑定纲[1] 庄见齐[1] 

机构地区：[1]汕头大学医学院第二附属医院感染病科/感染病学教研室,广东省汕头市515041

出　　处：《实用肝脏病杂志》2011年第4期259-261,共3页Journal of Practical Hepatology

基　　金：广东省科技计划项目(2008B030331235)

摘　　要：目的评价替比夫定(LdT)阻断乙型肝炎病毒宫内感染的作用和安全性。方法 28例慢性乙型肝炎孕妇自妊娠28周起口服LdT600mg/d至分娩后4周,30例血清HBV M标记物阳性孕妇不服抗病毒药为对照。在新生儿出生后给予HBIG和乙肝疫苗注射。结果在分娩前,治疗组孕妇HBV DNA为3.3±1.6lgcopies/ml,比用药前7.5±0.6lgcopies/ml明显下降(t=9.58,P<0.001),对照组孕妇HBV DNA水平无变化;治疗组无,而对照组却有4例(13.3%,x2=4.15,P<0.05)发生新生儿宫内HBV感染;两组孕妇分别有3例和2例血清CK轻度升高。结论慢性HBV感染孕妇在妊娠晚期服用LdT能有效降低宫内HBV感染发生率,且对孕妇无不良影响。Objective To evaluate the efficacy and safety of telbivudine in blocking intrauterine HBV transmission.Methods 28 pregnant women with chronic hepatitis B were treated by telbivudine（600mg/d）since 28 weeks of gestation to 4 weeks after delivery,and 30 pregnant women with HBV infection were without antiviral teatment.The newborn were given active/passive immunization.Results The HBV DNA levels in treatment group before delivery were significantly declined[7.5±0.6 lg copies/ml to 3.3±1.6lg copies/ml（t=9.59,P0.001）],while the serum HBV DNA levels in control group didn＇t change;the incidence of intrauterine HBV infection in control was 13.3%（4/30,x2=4.15,P0.05）,much higher than that in the treatment group（0%）;the untoward effect of telbivudine was mild and not different between the two group.Conclusion Telbivudine can reduce the incidence of intrauterine HBV infection in the late pregnant women with chronic hepatitis B viral infection.

关 键 词：慢性乙型肝炎 替比夫定 母婴传播 宫内感染 

分 类 号：R512.62[医药卫生—内科学]