拉米夫定治疗孕妇慢性乙型肝炎病毒感染的研究进展  

Research Progress of Lamivudine in the Treatment of Pregnant Women with Chronic Hepatitis B Virus Infection

作　　者：张静[1] 王玉平[2] 

机构地区：[1]蚌埠医学院,233030 [2]连云港市东方医院妇产科

出　　处：《国际妇产科学杂志》2017年第6期622-625,共4页Journal of International Obstetrics and Gynecology

摘　　要：据世界卫生组织(WHO)报告,全世界有二十多亿人有过去的或现在的乙型肝炎病毒(hepatitis B virus,HBV)感染的血清学证据,其中三亿五千万是慢性HBV携带者。越早感染,越有可能成为慢性乙型肝炎表面抗原(HBsAg)携带者。我国慢性HBV感染的主要原因是通过母婴传播。包括垂直传播(宫内传播、产时传播及母乳喂养)和日常接触传播。由于乙肝免疫球蛋白和乙肝疫苗的使用,母婴传播率已由90%降低到10%。尽管接受免疫预防,仍有10%~15%的婴儿通过母婴传播发展为慢性HBV感染者。因此母婴阻断显得尤为重要,拉米夫定一直被认为是治疗慢性乙型肝炎的有效药物。其在妊娠期使用,目前被列为妊娠C类药。越来越多的研究表明在孕晚期开始抗病毒治疗降低母婴传播是有效的且不影响胎儿发育。综述拉米夫定在慢性HBV感染孕妇中的使用。According to the WHO report, there are more than 2 billion people around the world have hepatitis B virus(HBV) infection in the past or present serological evidence, of which 350 million are chronic hepatitis B virus(HBV) carriers.The earlier infection, the more likely to be a chronic hepatitis B surface antigen(HBsAg) carrier. The main reason of chronic HBV infection in China is a through maternal-neonatal transmission, including vertical transmission(intrauterine transmission,intrapartum transmission and breastfeeding) and daily contact. Due to the use of hepatitis B vaccine and hepatitis B immunoglobulin, perinatal transmission rate decreases from 90% to 10%, although accepted immunoprophylaxis, there are still 10%-15% of babies become chronic HBV infection through mother to child transmission development. Therefore it is particularly important to PMTCT. Lamivudine has been considered to be the effective drug for the treatment of chronic hepatitis B in pregnancy and is classified as pregnancy category C. More and more studies show that the start of antiviral therapy in late pregnancy to reduce maternal-neonatal transmission is effective and does not affect fetal development. This paper reviews on the use of lamivudine in pregnant women with chronic HBV infection.

关 键 词：拉米夫定 肝炎病毒 乙型 孕妇 

分 类 号：R714.251[医药卫生—妇产科学]