替比夫定对合并慢性乙肝妊娠中晚期孕妇胎儿宫内感染率的影响  

Effect of telbivudine on fetal HBV intrauterine infection rate in chronic hepatitis B pregnant women during the second and the third trimesters of pregnancy

作　　者：吕丽岭[1] 卢建军[1] 

机构地区：[1]内蒙古医科大学附属医院,内蒙古呼和浩特010050

出　　处：《中国妇幼保健》2017年第8期1607-1609,共3页Maternal and Child Health Care of China

基　　金：内蒙古自治区自然科学基金项目(2014MS0849)

摘　　要：目的探讨替比夫定对合并慢性乙肝的妊娠中晚期孕妇胎儿宫内感染率的影响。方法选取内蒙古医科大学附属医院于2013年2月-2016年1月期间收治的142例合并慢性乙肝的妊娠中晚期孕妇,按照随机数字表法将所有孕妇分为研究组和对照组。研究组孕妇均口服替比夫定进行抗病毒治疗,对照组孕妇则口服复方甘草酸苷片进行治疗。在两组孕妇足月生产后,均抽取脐带血进行乙肝全项的检测,并且在24 h内对新生儿注射200 IU的乙肝免疫球蛋白和10μg的乙肝疫苗,序贯给予乙肝疫苗免疫。结果两组新生儿在出生及随访期间均没有肢体或功能畸形出现,并且两组新生儿的肝功能均正常,但是研究组新生儿出生时的脐带血HBV感染率显著低于对照组(χ~2=5.871,P<0.05)。研究组孕妇分娩后的肝功能存在明显好转,并且其HBV拷贝数显著低于对照组(均P<0.05);此外研究组的产后出血率为2.22%,显著低于对照组,两组比较,差异具有统计学意义(χ~2=9.512,P<0.05)。结论对于合并慢性乙肝的妊娠中晚期孕妇给予替比夫定进行抗病毒治疗能够有效阻断胎儿宫内感染的发生。Objective To explore the effect of telbivudine on fetal HBV intrauterine infection rate in chronic hepatitis B pregnant women during the second and the third trimesters of pregnancy. Methods A total of 142 chronic hepatitis B pregnant women during the second and the third trimesters of pregnancy treated in the hospital from February 2013 to January 2013 were selected and divided into study group and control group according to random number table. The pregnant women in study group were treated by oral administration of telbivudine,while the pregnant women in control group were treated by oral administration of compound glycyrrhizin tablets. After full-term delivery,umbilical cord samples were obtained for hepatitis B markers detection. The neonates within 24 hours after birth were injected by 200 IU hepatitis B immunoglobulin and 10 μg hepatitis B vaccine,sequential vaccination of hepatitis B vaccine was given. Results No limb or function deformity was found at birth and during follow-up of the neonates in the two groups. Liver functions of neonates in the two groups were normal. Umbilical cord blood HBV infection rate of neonates at birth in study group was statistically significantly lower than that in control group（ χ^2= 5. 871,P〈0. 05）. Liver function of postpartum women in study group was significantly improved,the copy number of HBV was statistically significantly lower than that in control group（ all P〈0. 05）. The rate of postpartum hemorrhage in study group was 2. 22%,which was statistically significantly lower than that in control group（ χ^2= 9. 512,P〈0. 05）. Conclusion Telbivudine can effectively block the occurrence of fetal intrauterine infection in treatment of chronic hepatitis B pregnant women during the second and the third trimesters of pregnancy.

关 键 词：慢性乙肝 妊娠中晚期 胎儿 宫内感染 替比夫定 

分 类 号：R512.62[医药卫生—内科学]