孕期全程抗病毒对孕妇肾功能和胎儿生长发育的影响  

Effects of anti-viral treatment during pregnancy on the renal function of mothers and fetal growth

作　　者：魏宏[1] 段钟平[2] 孟君[1] 庞秋梅[1] WEI Hong;DUAN Zhongping;MENG Jun;PANG Qiumei(Department of Obstetrics,Beijing You'an Hospital,Capital Medical University;Department of Internal Medicine,Affiliated Hospital of Capital Medical University,Beijing 100069,P.R.China)

机构地区：[1]首都医科大学附属北京佑安医院产科,北京100069 [2]首都医科大学附属医院内科,北京100069

出　　处：《中国计划生育和妇产科》2021年第5期51-53,58,共4页Chinese Journal of Family Planning & Gynecotokology

基　　金：国家卫生计生委医药卫生科技发展研究中心基金项目;国家科技重大专项“艾滋病和病毒性肝炎等重大传染病防治”(项目编号:2017ZX10201201-002-009)。

摘　　要：目的评估孕期全程抗病毒治疗对孕妇肾功能和胎儿生长发育的影响。方法回顾性分析2018年1月至2019年12月首都医科大学附属北京佑安医院分娩的足月单胎妊娠无其他合并症的138例乙肝患者,孕前1年开始口服替诺福韦至孕期全程(即服药时间为84~88周)的孕妇54例为观察组,选取同时段的孕24~28周口服抗病毒药物(即服药时间为12~16周)的孕妇84例为对照组,孕36周检测两组孕妇的血清磷、肾小球滤过率、肌酐、尿蛋白进行对比,出生时比较新生儿头围、身高、体重体格发育指标及记录胎儿丢失、出生缺陷、新生儿发生骨折事件。结果两组血清磷[(1.0±0.3)mmol/L vs(1.2±0.2)mmol/L]、血清肌酐[(48.0±4.4)umol/L vs(44.0±3.5)umol/L]、肾小球滤过率[(114.0±11.0)mL/min/1.73m^(2) vs(130.0±14.0)mL/min/1.73 m^(2)]、尿蛋白阳性发生率[3.70%(2/54)vs 3.57%(3/84)]比较,差异均无统计学意义(P>0.05);两组新生儿出生时体格发育指标相比:头围[(331.0±8.0)mmvs (329.0±6.0) mm]、身长[(50.0±2.0)cm vs (49.0±2.0)cm]、体重[(3 350.0±48.0)g vs (3 400.0±58.0)g]比较,差异均无统计学意义(P>0.05),无胎儿丢失及新生儿出生缺陷,研究组无新生儿发生骨折事件,对照组发生1例,差异无统计学意义(P>0.05)。结论孕期全程使用替诺福韦抗病毒治疗对母亲的肾功能和胎儿的生长发育无影响,初步显示对母儿安全性良好。Objective To evaluate the effect of anti-viral treatment during pregnancy on renal function of mothers and fetal growth.Methods A total of 138 full-term singleton pregnancies without other complications delivered in Beijing You’an Hospital Affiliated to Capital Medical University from January 2018 to December 2019 were retrospectively analyzed.54 cases of pregnant women who took tenofovir orally from one year before pregnancy to the whole course of pregnancy(84~88 weeks in total) were selected as the observation group, and 84 cases of pregnant women who took antiviral drugs orally from 24 to 28 weeks of pregnancy(12~16 weeks in total)were selected as the control group.Serum phosphorus, glomerular filtration rate, creatinine and urinary protein of pregnant women were measured at 36 weeks of pregnancy.The indexes of head circumference, height, weight and physical development were compared at birth, and the events of fetal loss, birth defect and neonatal fracture were recorded.Results Compared the serum phosphorus [(1.0±0.3) mmol/L vs(1.2±0.2) mmol/L],serum creatinine [(48.0±4.4) umol/L vs(44.0±3.5) umol/L],glomerular filtration rate [(114.0±11.0) mL/min/1.73 m^(2) vs(130.0±14.0) mL/min/1.73 m^(2)],positive rate of urinary protein [3.70%(2/54) vs 3.57%(3/84)] of the two groups, the differences were not statistically significant(P>0.05);the physical development indexes of the two groups at birth: head circumference [(331.0±8.0) mm vs(329.0±6.0) mm],body length [(50.0±2.0) cm vs(49.0±2.0)cm],weight [(3 350.0±48.0) g vs(3 400.0±58.0)g],the differences were not statistically significant(P>0.05),no fetal loss or birth defect, there was no neonatal fracture event in the study group and 1 case in the control group, and the difference was not statistically significant(P>0.05).Conclusion The use of tenofovir antiviral therapy during pregnancy has no effect on the renal function of the mother and the growth of the fetus, and it is initially shown to be safe for the mother and child.

关 键 词：全程抗病毒孕妇 肾功能 新生儿体格发育 

分 类 号：R714.51[医药卫生—妇产科学]