HBeAg阳性感染孕妇妊娠期中晚期接受替比夫定治疗对HBsAg、HBeAg及抗-HBc胎盘透过率的影响  

Effects of telbivudine on transmission of HBsAg and HBeAg through placenta in HBV infected pregnant women in second or third trimester

作　　者：吴全新[1] 邓国宏[1] 李俊男[2] 李利[2] 孙小雯[1] 潘美明[1] 黄鸿菲[1,3] 何登明[1] 晏泽辉[1] 徐城[1] 李茂仕[1] 唐薇[1] 刘明栋[1] 王宇明[1] 

机构地区：[1]第三军医大学西南医院全军感染病研究所,感染病研究重庆市重点实验室,重庆400038 [2]第三军医大学西南医院妇产科 [3]蚌埠医学院,安徽蚌埠233030

出　　处：《第三军医大学学报》2013年第7期665-668,共4页Journal of Third Military Medical University

基　　金：国家自然科学基金重点项目(30830090)~~

摘　　要：目的观察HBeAg阳性、HBV DNA高复制慢性HBV感染孕妇的HBsAg、HBeAg和抗-HBc胎盘透过率,进一步明确替比夫定阻断母婴传播的机制。方法回顾性分析在本院例行孕期检查以及产科分娩的HBeAg阳性、HBVDNA≥106IU/mL的慢性HBV感染孕妇84例,根据阻断HBV母婴传播方式不同分为常规双重免疫阻断组(常规组,15例)和双重免疫+替比夫定阻断组(替比夫定组,69例)。检测妊娠中晚期、分娩时母亲和新生儿脐带血清HBsAg、HBeAg及抗-HBc水平。结果两组之间母亲及新生儿HBsAg、HbeAg和抗-HBc水平无统计学差异(孕妇分娩时:HBsAg P=0.058,HBeAg P=0.065,抗-HBc P=0.727;新生儿脐血:HBsAg P=0.761,HBeAg P=0.225,抗-HBc P=0.924),且两组之间的HBsAg和HBeAg胎盘透过率亦无统计学差异(分别为P=0.172,0.163)。两组新生儿脐带血抗-HBc透过率均为阳性。结论妊娠中晚期替比夫定不能降低孕妇HBsAg、HBeAg水平和HBsAg、HBeAg的胎盘透过率,其阻断HBV母婴传播的机制可能主要与有效降低孕妇HBV DNA水平有关。透过率与母亲HBsAg和HBeAg水平不成平行关系。Objective To determine the through placenta in HBV infected pregnant women change of transmission of HBsAg, HBeAg and anti-HBC at the second and third trimesters after the treatment of telbivudinein. Methods We systematically investigated 69 mothers with HBeAg positive and HBV DNA levels i〉 106IU/mL who made routine pregnancy checks in our hospital from Feburary 2008 to October 2012 and received telbivudine at 600 mg per day from 24th to 33th week of gestation. Another 15 pregnant women at the same situation who were unwilling to receive the treatment served as control. All the mothers and the cordblood of infants were detected for the serum HBV markers （HBsAg, anti-HBs, HBeAg, anti-HBe, HBV DNA）. Results There was no significant difference in serum levels of HBsAg, HBeAg and anti-HBC titers in the mothers and their infants from either the telbivudine group or the untreated group （ serum of mothers at delivery, HBsAg P =0.058, HBeAg P =0.065; blood of infants, HBsAg P =0.761, HBeAg P =0.225）. There was alson no difference of the transmission rate of HBsAg and HBeAg between two groups （P = 0. 172 and P = 0. 163）. The sesum anti-HBc could absolutely transit the placenta in the two groups. Conclusions We demonstrated that telbivudine couldn＇ t effectivly downregrade the levels of serum HBsAg and HBeAg of the mothers and the transmission rate of cordblood in the telbivudine preventing mother serum HBsAg and to infant transmission HBeAg in the mother might be due is not parallel to its declining group. The mechanism the levels of HBV DNA. to the transmission rate of cordblood and of telbivudine The levels of the mothers.

关 键 词：替比夫定 HBsAg HBEAG 宫内传播 透过率 

分 类 号：R373.2[医药卫生—病原生物学] R714.251[医药卫生—基础医学]