乙肝母婴阻断停药后观察分析  

Observation and analysis of prevention of maternal-infant transmission of viral hepatitis B after drug withdrawal

作　　者：刘三娣 范银白 龙丽娟 蓝裕玲 LIU San-di;FAN Yin-bai;LONG Li-juan(Ganzhou Fifth People's Hospital,Ganzhou 341000,China)

机构地区：[1]赣州市第五人民医院,341000

出　　处：《中国现代药物应用》2023年第8期91-93,共3页Chinese Journal of Modern Drug Application

基　　金：赣州市指导性科技计划项目(项目编号:GZ2018ZSF417)。

摘　　要：目的探究乙型病毒性肝炎(乙肝)孕妇进行药物阻断停药后的肝功能变化情况。方法80例乙肝孕妇,随机分为观察组和对照组,每组40例。对照组孕妇不进行药物阻断,观察组孕妇于妊娠24~28周时开始进行药物阻断,于分娩后停药。比较两组入组时及分娩后1、3、6个月肝功能指标[谷草转氨酶(AST)、谷丙转氨酶(ALT)]水平、乙型肝炎病毒的脱氧核糖核酸(HBV-DNA)载量,观察组停药后1、3、6个月肝功能异常发生率。结果分娩后1、3、6个月,观察组AST水平分别为(22.42±6.54)、(28.22±6.44)、(29.60±6.34)U/L,明显低于对照组的(33.46±7.42)、(32.69±6.39)、(35.33±7.42)U/L,差异具有统计学意义(P<0.05)。分娩后1、3、6个月,观察组ALT水平分别为(16.56±6.59)、(21.13±6.59)、(22.56±6.92)U/L,明显低于对照组的(24.23±7.45)、(24.46±7.62)、(27.43±7.68)U/L,差异具有统计学意义(P<0.05)。分娩后1个月,观察组HBV-DNA载量为(5.94±0.38)log copies/ml,明显低于对照组的(7.39±0.52)log copies/ml,差异具有统计学意义(P<0.05);分娩后3、6个月,两组HBV-DNA载量比较差异无统计学意义(P>0.05)。观察组停药后1、3、6个月肝功能异常发生率分别为7.50%(3/40)、7.50%(3/40)、12.50%(5/40),比较差异无统计学意义(P>0.05)。结论替比夫定、替诺福韦可用于乙肝母婴阻断,可显著降低孕妇HBV-DNA载量,但停药后要注意按时进行复诊,避免肝功能指标及HBV-DNA载量水平升高。Objective To investigate the changes of liver function in pregnant women with prevention of maternal-infant transmission of viral hepatitis B after drug withdrawal.Methods A total of 80 pregnant women with viral hepatitis B were randomly divided into observation group and control group,with 40 cases in each group.Pregnant women in the control group did not receive drug blocking,while pregnant women in the observation group started drug blockade at 24-28 weeks of gestation and discontinued the drug after delivery.The liver function indexes[aspartate transaminase(AST),alanine transaminase(ALT)]levels and hepatitis B virus deoxyribonucleic acid(HBV-DNA)load of hepatitis B virus at the time of enrollment and 1,3 and 6 months after delivery were compared between the two groups,and the incidence of abnormal liver function at 1,3 and 6 months after drug withdrawal was observed in the observation group.Results At 1,3 and 6 months after delivery,AST levels in the observation group were(22.42±6.54),(28.22±6.44)and(29.60±6.34)U/L,which were significantly lower than those of(33.46±7.42),(32.69±6.39)and(35.33±7.42)U/L in the control group,and the differences were statistically significant(P<0.05).At 1,3 and 6 months after delivery,ALT levels in the observation group were(16.56±6.59),(21.13±6.59)and(22.56±6.92)U/L,which were significantly lower than those of(24.23±7.45),(24.46±7.62)and(27.43±7.68)U/L in the control group,and the differences were statistically significant(P<0.05).At 1 month after delivery,the HBV-DNA load in the observation group was(5.94±0.38)log copies/ml,which was significantly lower than that of(7.39±0.52)log copies/ml in the control group,and the difference was statistically significant(P<0.05).At 3 and 6 months after delivery,there was no statistically significant difference in HBV-DNA load between the two groups(P>0.05).The incidences of abnormal liver function were 7.50%(3/40),7.50%(3/40)and 12.50%(5/40)in the observation group at 1,3 and 6 months after drug withdrawal,and there was no sta

关 键 词：母婴阻断 乙型病毒性肝炎 肝功能 替比夫定 替诺福韦 

分 类 号：R714.251[医药卫生—妇产科学]