富马酸替诺福韦酯治疗HBV感染孕妇的疗效及垂直传播阻断效果  

Effect of tenofovir disoproxil fumarate on treatment of pregnant women with HBV infection and blocking vertical transmission

作　　者：阴敏[1] 唐亮[1] 姜百灵 YIN Min;TANG Liang;JIANG Bai-ling(Panzhihua Maternal and Child Health Hospital,Panzhihua,Sichuan 617000,China)

机构地区：[1]攀枝花市妇幼保健院围产保健科

出　　处：《中华医院感染学杂志》2019年第23期3632-3636,共5页Chinese Journal of Nosocomiology

基　　金：四川省自然科学基金资助项目(2016089102)

摘　　要：目的探讨孕期乙型肝炎病毒(hepatitis B virus,HBV)感染者使用富马酸替诺福韦酯治疗,对丙氨酸转氨酶(alanine aminotransferase,ALT)复常率和HBV-DNA转阴率及阻断母婴垂直传播的效果。方法选取2016年1月-2018年1月在攀枝花市妇幼保健院内孕期建档常规产检的HBV感染孕妇80例,根据治疗意愿将孕妇分为治疗组(46例)与对照组(34例),对照组孕妇在妊娠期常规给予保肝治疗,治疗组给予富马酸替诺福韦酯治疗,两组分娩新生儿出生后常规给予免疫阻断。观察两组孕妇在孕30周、35周、分娩前的ALT复常率、HBV-DNA转阴率,检测婴儿出生时及6个月龄时乙肝表面抗原(hepatitis B surface antigen,HBsAg)、乙肝表面抗体(hepatitis B surface antibody,HBsAb)表达。结果治疗组孕30周、35周、分娩前ALT复常率分别为52.17%、86.96%、95.65%,高于对照组29.41%、44.12%、52.94%,比较差异有统计学意义(P<0.05);治疗组孕30周、35周、分娩前HBV-DNA转阴率分别为43.48%、76.09%、86.96%,高于对照组20.59%、35.29%、44.12%,比较差异有统计学意义(P<0.05);治疗组孕妇分娩婴儿出生时、6个月龄时HBsAg阳性率分别为4.35%、0,低于对照组20.59%、11.76%,比较差异有统计学意义(P<0.05);治疗组孕妇分娩婴儿出生时、6个月龄时HBsAb阳性率分别为36.96%、76.09%,高于对照组5.88%、8.82%,比较差异有统计学意义(P<0.05)。结论HBV感染孕妇给予富马酸替诺福韦酯孕期治疗可提高ALT复常率及HBV-DNA转阴率,且能有效阻断HBV母婴垂直传播。OBJECTIVE To explore the effect of tenofovir disoproxil fumarate on normalization rate of alanine aminotransferase(ALT),negative concersion rate of HBV-DNA and blocking mother-to-infant vertical transmission of patients with hepatitis B virus(HBV)infection.METHODS Totally 80 cases of HBV infected pregnant women on routine prenatal examination and filing during pregnancy in Panzhihua Maternal and Child Health Hospital from January 2016 to January 2018 were enrolled in this study.The pregnant women were divided into treatment group(46 cases)and control group(34 cases)according to their treatment willingness.The control group received routine liver protection treatment during pregnancy,while the treatment group received tenofovir fumarate treatment.Newborns of two groups were routinely given immune interruption after birth.ALT normalization rate and HBV-DNA negative conversion rate of two groups were detected in the pregnancy of 30 weeks,35 weeks,and before delivery.The expression of hepatitis B surface antigen(HBsAg)and hepatitis B surface antibody(HBsAb)of infants were examined at birth and 6 months later.RESULTS ALT normalization rate of treatment group in pregnancy 30 weeks,35 weeks and before delivery were 52.17%,86.96% and 95.65%,which was significantly higher than that of the control group(29.41%,44.12% and 52.94%,respectively)(P<0.05).HBV-DNA negative conversion rate were 43.48%,76.09% and 86.96% in treatment group in pregnancy 30 weeks,35 weeks and before delivery,compared to 20.59%,35.29% and 44.12% of the control group,the difference was significant(P<0.05).HBsAg positive rate in the treatment group at birth(4.35%)and 6-month-old child(0%)were significantly lower than that in the control group at birth(20.59%)and 6-month-old child(11.76%)(P<0.05).HBsAb positive rate were 36.96% and 76.09% of treatment group at birth and 6 months later,5.88% and 8.82% of control group at birth and 6 months later,and the difference was significant(P<0.05).CONCLUSION ALT normalization rate and HBV-DNA negative conversion rat

关 键 词：乙型肝炎病毒 感染 孕妇 富马酸替诺福韦酯 丙氨酸转氨酶 HBV-DNA 母婴垂直传播 

分 类 号：R714.251[医药卫生—妇产科学]