HBV高载量孕妇孕期抗病毒治疗结合标准阻断措施阻断母婴传播效果  

Effect of antiviral therapy combined with standard blocking measures for preventing mother-to-child transmission of hepatitis B virus(HBV)of pregnant women with high viral load of HBV

作　　者：杨敏 李红梅 张雷[1] 何流[1] 邓强 江海燕 YANG Min;LI Hongmei;ZHANG Lei;HE Liu;DENG Qiang;JIANG Haiyan(Guang'an People's Hospital,Guang'an,Sichuan Province,638000)

机构地区：[1]四川省广安市人民医院,638000

出　　处：《中国计划生育学杂志》2024年第5期1153-1157,共5页Chinese Journal of Family Planning

摘　　要：目的:探究乙型肝炎病毒(HBV)高载量孕妇孕期HBV-DNA水平和乙型肝炎病毒e抗原(HBeAg)阳性情况,分析孕期抗病毒治疗结合标准阻断措施对HBV高载量孕妇母婴传播阻断效果。方法:回顾性收集2021年1月-2023年1月本院住院分娩的120例HBV高载量孕妇临床资料,分析孕妇妊娠期、分娩前HBV-DNA水平和HBeAg阳性率,多因素logistic回归分析HBeAg状态影响因素,分析孕期抗病毒治疗对新生儿乙肝母婴传播阻断效果及母婴安全性。结果:120例HBV高载量孕妇中,孕期接受抗病毒治疗93例(治疗组),抗病毒药物分别为替诺福韦占56.6%、拉米夫定占20.8%;未接受治疗27例(未治疗组)。妊娠期,抗病毒治疗组和未治疗组HBV-DNA载量、HBeAg阳性率无差异(P>0.05);分娩前,抗病毒治疗组HBV-DNA载量≥10^(6)IU/ml占比(7.5%)低于未治疗组(92.6%)(P<0.05),而两组HBeAg阳性率(90.3%、92.6%)无差异(P>0.05)。多因素logistic分析,年龄低、HBVDNA载量高影响HBeAg状态的独立危险因素(P<0.05)。新生儿乙肝母婴传播阻断率抗病毒治疗组(100.0%)高于未治疗组(2例,92.6%)(P<0.05)。两组新生儿体质量、早产、剖宫产、妊娠合并症、产时并发症比较无差异(P>0.05)。结论:HBV高载量孕妇HBV-DNA水平较高,HBeAg阳性率与孕妇年龄低、HBV-DNA载量高有关;孕期抗病毒治疗可降低孕妇分娩前HBV-DNA水平,结合标准阻断措施后可提高HBV母婴传播阻断率,且安全性较好。Objective:To investigate the level of hepatitis B virus(HBV)-DNA and the HB e antigen(HBeAg)positivity situation of pregnant women with high HBV load,and to analyze the effect of the antiviral treatment combined with standard blocking measures for preventing mother-to-child transmission of HBV during pregnancy.Methods:The clinical data of 120pregnant women with high HBV load who gave birth in the hospital from January 2021to January 2023were collected retrospectively.The HBV-DNA level and the HBeAg positive rate of the women during pregnancy and before delivery were analyzed.Multivariate logistic regression analysis was conducted to identify the factors influencing of the positive HBeAg situation of the women.The efficacy and safety of the antiviral therapy for preventing mother-to-child transmission of HBV of the women during pregnancy were analyzed.Results:Among 120pregnant women with the high HBV load,there were 93cases had received antiviral therapy during pregnancy(in study group),including 56.6%women treated by tenofovir and 20.8%women treated by lamivudine,and there were 27cases hadn’t received the antiviral therapy during pregnancy(in control group).There were no significant differences in the HBV-DNA load and the HBeAg positive rate of the women between the two groups(P>0.05).The proportion(7.5%)of the women with HBV-DNA load≥10^(6)IU/ml before delivery in the study group was significantly lower than that(92.6%)of the women in the control group(P<0.05),while there was no significant difference in the rate of positive HBeAg(90.3%vs.92.6%)of the women between the two groups(P>0.05).Multivariate logistic analysis showed that the less age and the high HBV-DNA load of the women were the independent risk factors for their positive HBeAg status(P<0.05).The rate of preventing mother-to-child transmission of HBV(100.0%)of the women in the study group was significantly higher than that(92.6%)of the women in the control group(P<0.05).There were no significant differences in the neonatal weight,and the rates of

关 键 词：孕妇 乙型肝炎病毒 病毒DNA载量 乙肝E抗原 抗病毒治疗 母婴传播阻断 

分 类 号：R714.251[医药卫生—妇产科学]