替比夫定与乙型肝炎疫苗及免疫球蛋白联合阻断乙型肝炎病毒母婴垂直传播的研究  

Effect of telbivudine combined with hepatitis B vaccine and immune globulin on blocking mother-infant vertical transmission of hepatitis B virus

作　　者：彭美莲[1] 刘玮[1] 吕雯 庞玉良[1] 

机构地区：[1]浙江省立同德医院妇产科,浙江杭州310032

出　　处：《中华医院感染学杂志》2014年第1期15-16,33,共3页Chinese Journal of Nosocomiology

基　　金：浙江省医药卫生研究计划基金项目(2012KYB042)

摘　　要：目的观察替比夫定与乙型肝炎疫苗、免疫球蛋白联合在阻断乙型肝炎病毒母婴垂直传播中的疗效。方法将2011年1月-2012年1月携带乙型肝炎病毒的孕妇随机分成两组,对照组采用乙型肝炎免疫球蛋白(HBIG)与乙型肝炎疫苗联合治疗,观察组在此基础上口服替比夫定600mg,1次/d;比较两组患者间治疗前和分娩前乙型肝炎核心抗体(HBcAb)、乙型肝炎病毒e抗原(HBeAg)、乙型肝炎病毒的脱氧核糖核酸(HBV-DNA)的差异及出生后24h、6、12个月HBsAg阳性率。结果治疗前两组孕妇间血清HBcAb、HBeAg、HBV-DNA水平差异无统计学意义;分娩前观察组血清HBeAg、HBV-DNA水平分别为(165.28±236.56)s/co、(0.67±0.62)106拷贝/ml,对照组分别为(467.38±368.41)s/co和(4.28±2.17)106拷贝/ml;婴儿间出生后24h、6、12个月HBsAg阳性率分别为16.67%、3.33%、3.33%,显著低于对照组同时期的36.67%、26.67%、16.67%。结论替比夫定联合乙型肝炎疫苗、免疫球蛋白能有效阻断乙型肝炎病毒母婴垂直传播,疗效显著优于乙型肝炎疫苗、免疫球蛋白方案。OBJECTIVE To observe the efficacy of telbivudine combined with hepatitis B vaccine and immune globulin in blocking mother-infant vertical transmission of hepatitis B virus.METHODS The pregnant women who were diagnosed with chronic hepatitis B during the period from Jan 2011to Jan 2012were randomly divided into two groups,the control group was taken with hepatitis B immune globulin（HBIG）combined with hepatitis B vaccine treatment,and the observation group was given the oral administration of telbivudine 600mg on the basis of the control group,once per day;the differences in the hepatitis B core antibody（HBcAb）,hepatitis B virus e antigen（HBeAg）,and hepatitis B virus deoxyribonucleic acid（HBV-DNA）were compared before the treatment and before the childbirth,and the positive rates of the HBsAg at 24hours,6months,and 12months after the childbirth were compared.RESULTS The difference in the level of serum HBcAb,HBeAg,or HBV-DNA before the treatment between the two groups was not significant;the level of serum HBeAg before the childbirth was（165.28 ±236.56）s/co in the observation group,（467.38±368.41）s/co in the control group;the level of HBV-DNA before the childbirth was（0.67±0.62）106 copies/ml in the experimental group,（4.28±2.17）106 copies/ml in the control group.The positive rates of the HBsAg at 24hours,6months,and 12months after the childbirth were respectively 16.67%,3.33%,and 3.33% in the experimental group,significantly lower than 36.67%,26.67%, and 16.67% in the control group.CONCLUSIONTelbivudine combined with hepatitis B vaccine and immune globulin can effectively block the vertical transmission of hepatitis B virus,with the efficacy significantly better than the program of hepatitis B vaccine and immune globulin.

关 键 词：乙型肝炎病毒 母婴阻断 替比夫定 乙型肝炎疫苗 免疫蛋白 

分 类 号：R512.62[医药卫生—内科学]