不同孕期抗病毒治疗对高HBV-DNA病毒载量孕妇母婴传播阻断免疫效率的影响  

Effect of antiviral therapy during different periods of pregnancy on the immune efficiency of maternal and infant transmission blocking of high HBV-DNA viral load in pregnant women

作　　者：黄海燕[1] 王淼[1] 周建华[1] HUANG Hai-yan WANG Miao ZHOU Jian-hua.(Department of Gynecology and Obstetrics, The Third People＇s Hospital of Shenzhen, Guangdong 518000, China)

机构地区：[1]深圳市第三人民医院妇产科,广东518000

出　　处：《中国优生与遗传杂志》2016年第11期72-73,96,共3页Chinese Journal of Birth Health & Heredity

基　　金：基金项目<核苷类似物抗病毒治疗阻断乙肝母婴传播的疗效评估和机制研究>;项目编号:20120322218

摘　　要：目的研究不同孕期高病毒载量(HBV-DNA)病毒载量孕妇抗病毒治疗对母婴传播阻断免疫效率的影响。方法临床纳入120例我院2012年1月至2013年12月期间产科门诊收治的乙肝表面抗原(HBs Ag)阳性高HBV-DNA的孕妇作为研究对象(所有对象采用荧光定量PCR技术检测HBV-DNA病毒载量,其中HBV-DNA病毒载量>106拷贝/ml为高病毒载量)。将患者按随机数字表法分为4组各30例,分别为实验一组、实验二组、实验三组及对照组,分别在产妇孕20w、24w、28w口服替比夫定至分娩,对照组则不给予治疗。观察4组孕妇分娩时新生儿HBV-DNA病毒载量、HBs Ag、HBe Ag定量情况。结果治疗前4组患者ALT、HBV-DNA、HBs Ag以及HBe Ag水平均无差异,P>0.05;治疗后实验一组上述指标均明显低于实验二组、三组及对照组;且实验二组均低于实验三组;实验三组均低于对照组,均P﹤0.05。随访新生儿7-12月,发现实验一组ALT异常率及HBs Ag阳性率均低于实验二组、三组及对照组,实验二组均低于实验三组及对照组,实验三组均低于对照组,均P﹤0.05。结论对孕妇进行抗病毒治疗可有效阻止新生儿HBV病毒的感染,且治疗时间越早,HBV感染率越低,值得临床应用及推广。Objective： To study the effects of antiviral therapy during different periods of pregnancy on the immune efficiency of maternal and infant transmission blocking of high HBV-DNA viral load in pregnant women. Methods： 120 cases of hepatitis B surface antigen （HBsAg） positive high HBV-DNA of pregnant women in our hospital from January 2012 to December 2013 in obstetric clinic were selected as the research object （all objects used fluorescence quantitative PCR to detect HBV-DNA load, which HBV-DNA load〉106 copies/ml in high viral load） .Patients according to the random number table method were divided into four groups, each group had 30 cases, respectively as first experimental group, second experimental group and third experimental group and control group, respectively oral telbivudine to delivery in maternal 20, 24, 28 weeks, the control group was not treated. The HBV-DNA viral load, HBsAg and HBeAg were observed in four groups of pregnant women during delivery. Results： Before treatment, four groups of patients with ALT, HBV-DNA, HBsAg and HBeAg levels were no difference, P〉0.05. After treatment, first experimental group was significantly lower than second experimental group, third experimental group and control group, and second experimental group was lower than third experimental group, third experimental group was lower than control group, both P 〈 0.05.Neonates were followed up 7-12 months, found that HBsAg positive rate and the rate of abnormal ALT in first experimental group were lower than second experimental group, third experimental group and control group, and second experimental group were lower than those of third experimental group and control group, and third experimental group were lower than that of control group, all P 〈 0.05. Conclusion.. Anti viral therapy for pregnant women can effectively prevent the infection of neonatal HBV virus, and the earlier treatment time, the lower the HBV infection rate, it is worth clinical application and promotion.

关 键 词：孕期 抗病毒 HBV-DNA病毒载量 母婴传播 治疗 影响 

分 类 号：R714.251[医药卫生—妇产科学]