替比夫定与替诺福韦酯应用于乙型肝炎病毒感染免疫耐受期孕妇阻断治疗中的效果  

Efficacy of Tibivudine and Tenofovir Dipivoxil in Blocking Treatment of Pregnant Women Infected with Hepatitis B Virus during Immune Tolerance

作　　者：刘珺[1] 吴婕[1] LIU Jun;WU Jie(Department of Obstetrics,the First People's Hospital of Yunnan Province,The Affiliated Hospital of Kunming University of Science and Technology,Kunming 650032,China)

机构地区：[1]云南省第一人民医院(昆明理工大学附属医院)产科,昆明650032

出　　处：《中国药物经济学》2024年第1期71-74,78,共5页China Journal of Pharmaceutical Economics

摘　　要：目的 探讨替比夫定与替诺福韦酯应用于乙型肝炎病毒(HBV)感染免疫耐受期孕妇阻断治疗中的效果。方法 选取2019年5月至2021年10月云南省第一人民医院(昆明理工大学附属医院)收治的104例感染HBV孕妇作为研究对象,采用单双号法随机分为替比夫定组和替诺福韦酯组,各52例。记录两组治疗后新生儿HBV感染情况及母婴传播阻断情况,检测两组患者治疗前后肝功能指标,包括血清白蛋白(ALB)、总胆红素(TBIL)、丙氨酸转氨酶(ALT)及天冬氨酸转氨酶(AST)水平,监测患者乙肝病毒的脱氧核糖(HBV-DNA)水平与新生儿出生时及月龄12个月时体重、身长变化,并记录治疗过程中两组患者不良反应发生情况。结果 出生后7个月时替诺福韦酯组新生儿乙肝表面抗原(HBs Ag)、乙型肝炎e抗原(HBe Ag)检测结果阳性率低于替比夫定组,母婴传播阻断率高于替比夫定组,差异有统计学意义(P<0.05)。治疗后两组孕妇ALB水平较治疗前均升高,且替诺福韦酯组ALB水平较替比夫定组更高,差异有统计学意义(P<0.05);治疗后两组孕妇TBIL、ALT、AST水平均降低,且替诺福韦酯组较替比夫定组下降更多,差异有统计学意义(P<0.05)。治疗后两组孕妇HBV-DNA水平较治疗前均降低,且替诺福韦酯组低于替比夫定组,差异有统计学意义(P<0.05)。月龄12个月时,两组新生儿体重、身长均较出生时增加(P<0.05),但两组间比较差异无统计学意义(P>0.05)。两组不良反应发生率比较差异无统计学意义(P>0.05)。结论 替比夫定与替诺福韦酯应用于HBV感染免疫耐受期孕妇阻断治疗中均可改善孕妇肝功能,但替诺福韦酯改善效果更好且阻断率更高。Objective To explore the effect of Tibivudine and tenofovir dixil on blocking treatment of pregnant women with immune tolerance of hepatitis B virus(HBV) infection.Methods A total of 104 HBV-infected pregnant women admitted to the Affiliated Hospital of Kunming University of Science and Technology in the First People's Hospital of Yunnan Province from May 2019 to October 2021 were selected as the study objects.They were randomly divided into Tibivudine group and Tenofovir dixil group by odd-even method,with 52 cases in each group.Neonatal HBV infection and block of mother-to-child transmission were recorded in the two groups after treatment.Liver function indexes,including serum albumin(ALB),total bilirubin(TBIL),alanine aminotransferase(ALT) and aspartate aminotransferase(AST),were detected before and after treatment in the two groups.The level of HBV deoxyribose(HBV-DNA) and the weight and length of newborns at birth and 12 months of age were monitored,and the occurrence of adverse reactions in the two groups of patients during treatment was recorded.Results At 7 months after birth,the positive rate of hepatitis B surface antigen(HBsAg) and hepatitis Be antigen(HBeAg) in Tenofovir dixil group was lower than that in Tibivudine group,and the blocking rate of mother-to-child transmission was higher than that in Tibivudine group,with statistical significance(P<0.05).After treatment,the ALB level of pregnant women in both groups was higher than that before treatment,and the ALB level in tenofovir dipivoxil group was higher than that in Telbivudine group,the difference was statistically significant(P<0.05).After treatment,the levels of TBIL,ALT and AST were decreased in both groups,and the levels in Tenofovir dixil group were more decreased than that in Tibivudine group,with statistical significance(P<0.05).After treatment,the HBV-DNA level of pregnant women in both groups was lower than that before treatment,and the tenofovir dixil group was lower than that of Tibivudine group,with statistical significance(P<0.05).A

关 键 词：替比夫定 替诺福韦酯 乙型肝炎病毒感染免疫耐受期 孕妇 阻断 

分 类 号：R512.6[医药卫生—内科学] R978.7[医药卫生—临床医学]