慢性乙型肝炎妊娠患者应用替诺福韦酯进行母婴阻断的有效性和安全性评价  

Effectiveness and security of tenofovir disoproxil for prevention of mother-to-child transmission in pregnant patients with chronic hepatitis B

作　　者：程芳[1] 陈毅华 岳春霞[1] 胡敏[1] 齐明华[1] CHENG Fang;CHEN Yi-hua;YUE Chun-xia(Department of Infectious Diseases,Peking University Shenzhen Hospital,Beijing 518036,China)

机构地区：[1]北京大学深圳医院感染性疾病科,518036

出　　处：《中国现代药物应用》2022年第13期117-120,共4页Chinese Journal of Modern Drug Application

摘　　要：目的探讨慢性乙型肝炎妊娠患者应用替诺福韦酯进行母婴阻断的有效性和安全性。方法130例慢性乙型肝炎妊娠患者,按照随机数字表对照法分为观察组和对照组,每组65例。对照组接受常规保肝治疗,观察组在对照组治疗基础上联合替诺福韦酯治疗。比较两组患者治疗前后血清丙氨酸氨基转移酶(ALT)、乙型肝炎病毒脱氧核糖核酸(HBV-DNA)水平以及治疗后不良反应发生情况;新生儿出生5 min时Apgar评分、乙型肝炎病毒感染情况。结果治疗后,观察组患者血清ALT(27.03±4.99)U/L、HBV-DNA(2.53±0.39)IU/ml均低于对照组的(52.18±7.34)U/L、(5.31±0.32)IU/ml,差异均具有统计学意义(P<0.05)。观察组新生儿出生5 min时Apgar评分为(9.66±0.32)分,与对照组的(9.58±0.35)分比较,差异无统计学意义(t=1.360,P>0.05);观察组新生儿在出生时、6月龄、12月龄时的乙型肝炎表面抗原(HBsAg)阳性率、乙型肝炎e抗原(HBeAg)阳性率、HBV-DNA≥100 IU/ml发生率均为0,对照组新生儿在出生时、6月龄、12月龄时的HBsAg阳性率分别为13.85%、10.77%、10.77%,HBeAg阳性率分别为12.31%、9.23%、7.69%,HBV-DNA≥100 IU/ml发生率分别为12.31%、6.15%、6.15%;观察组新生儿在出生时、6月龄、12月龄时的HBsAg阳性率、HBeAg阳性率、HBV-DNA≥100 IU/ml发生率均低于同期对照组,差异均具有统计学意义(P<0.05)。两组患者治疗后均仅发生轻度不良反应,未经特殊处理自行消失。两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论慢性乙型肝炎妊娠患者应用替诺福韦酯进行母婴阻断效果较好,可以改善血清ALT、HBV-DNA水平,降低新生儿在出生时、6月龄、12月龄时的HBsAg阳性率、HBeAg阳性率、HBV-DNA≥100 IU/ml发生率,不影响新生儿出生5 min时Apgar评分。Objective To discuss the effectiveness and security of tenofovir disoproxil for prevention of mother-to-child transmission in pregnant patients with chronic hepatitis B.Methods A total of 130 pregnant patients with chronic hepatitis B were divided into observation group and control group according to the random numerical table,with 65 cases in each group.The control group received conventional liver protection therapy,and the observation group was combined with tenofovir dipivoxil therapy on the basis of the control group.Both groups were compared in terms of serum alanine aminotransferase(ALT)and hepatitis B virus deoxyribonucleic acid(HBV-DNA)before and after treatment,the occurrence of adverse reactions after treatment,neonatal Apgar score at 5 min after birth,and hepatitis B virus infection.Results After treatment,the serum ALT(27.03±4.99)U/L and HBV-DNA(2.53±0.39)IU/ml in observation group were lower than(52.18±7.34)U/L and(5.31±0.32)IU/ml ml in control group,and the differences were statistically significant(P<0.05).The neonatal Apgar score at 5 min after birth in the observation group was(9.66±0.32)points,which was not statistically significant compared with(9.58±0.35)points in the control group(t=1.360,P>0.05).In the observation group,the hepatitis B surface antigen(HBsAg)positive rate,hepatitis B e antigen(HBeAg)positive rate and incidence rate of HBV-DNA≥100 IU/ml of neonates at birth,6 months and 12 months of age were all 0.In the control group,the HBsAg positive rates of neonates at birth,6 months,and 12 months were 13.85%,10.77%,and 10.77%,the HBeAg positive rates were 12.31%,9.23%,and 7.69%,and the incidence rates of HBV-DNA≥100 IU/ml were 12.31%,6.15%,and 6.15%.The HBsAg positive rate,HBeAg positive rate and the incidence rate of HBVDNA≥100 IU/ml at birth,6 months and 12 months of age of the neonates in the observation group were lower than those in the control group at the same period,and the differences were statistically significant(P<0.05).There were only mild adverse reactions in b

关 键 词：慢性乙型肝炎 妊娠 替诺福韦酯 母婴阻断 有效性 安全性 

分 类 号：R714.251[医药卫生—妇产科学]