妊娠期乙肝患者服用替诺福韦后阻断宫内乙肝病毒传播疗效及安全性  

Efficacy and safety of tenofovir for blocking hepatitis B virus intrauterine transmission

作　　者：崔璐[1] 蔡秋娥[1] 王淼[1] 王素华[1] CUI Lu;CAI Qiue;WANG Miao;WANG Suhua(The Third People's Hospital of Shenzhen,Guangdong Province,518000)

机构地区：[1]深圳市第三人民医院,518000

出　　处：《中国计划生育学杂志》2020年第10期1658-1660,共3页Chinese Journal of Family Planning

基　　金：深圳市卫生系统科研项目(SZFZ2018060)。

摘　　要：目的:探讨乙肝患者妊娠期服用替诺福韦后阻断乙型肝炎病毒宫内传播的疗效及安全性。方法:回顾性收集本院不同时期收治的乙型肝炎妊娠孕妇临床资料,2011年1月-2014年12月446例(对照组)行常规干预;2015年1月-2018年12月591例(观察组)妊娠24~28周起服用替诺福韦。观察两组血清HBV DNA载量、围生期不良反应、新生儿成长发育情况(身长、头围和体质量)及婴儿高病毒载量阳性情况。结果:血清HBV DNA载量,观察组服药前与对照组比较无差异(P>0.05),分娩前观察组病毒载量[(3.21±0.14)×10^8拷贝/ml]低于对照组[(7.14±1.09)×10^8拷贝/ml],围生期不良反应发生率观察组(1.7%)低于对照组(3.8%)(均P<0.05)。新生儿身长、头围、体质量等观察组与对照组比较无差异(P>0.05),婴儿高病毒载量阳性发生率观察组无发生,对照组为0.7%(P<0.05)。结论:乙型肝炎孕妇妊娠期服用替诺福韦可有效降低母婴病毒传播几率,降低婴儿高病毒载量的阳性率,且未增加胎儿不良结局发生,值得临床应用。Objective: To investigate the efficacy and safety of tenofovir for blocking hepatitis B virus intrauterine transmission of pregnant women. Methods: the data of 446 pregnant women with hepatitis B were conlected retrospectively. 446 women from January 2011 to December 2014 were given routine intervention in control group, and 591 pregnant women from January 2015 to December 2018 in observation group were given tenofovir from 24-28 gestational weeks. Serum HBV DNA load, perinatal adverse reaction rate, situation of neonatal growth and development(length, head circumference, and body mass) and rate of high infant viral load of infants in the two groups were observed. Results: There was no significant difference in serum HBV DNA load of women before treatment between the two groups(P>0.05). The serum HBV DNA load of women in the observation group before delivery was(3.21±0.14)×10^8 copy/ml, which was significant lower than that((7.14±1.09)×10^8 copy/ml) of women in the control group(P<0.05). The incidence of adverse reaction during the perinatal period of women in the observation group was 1.7%, which was significant lower than that(3.8%) of the control group(all P<0.05). There were no significant different in the length, head circumference, and body mass of the newborns between the two groups(P>0.05). The positive rate of high viral load of newborns in the control group was 0.7%, which was significant higher than that(0%) in the observation group(P<0.05). Conclusion: Tenofovir used for treating the pregnant women with hepatitis B during pregnancy can effectively reduce the rate of mother-to-child transmission of hepatitis viru B, reduce the high viral load of infants, and has little adverse effect on the fetus, which is worthy of clinical application.

关 键 词：妊娠 乙型肝炎病毒 替诺福韦 母婴传播 阻断 婴儿高病毒载量 

分 类 号：R714.251[医药卫生—妇产科学]