【摘要】：目的比較替諾福韋、替比夫定妊娠期口服對(duì)乙肝病毒(HBV)母嬰傳播的阻斷效果及安全性。方法153例HBV感染的孕婦,其中替諾福韋組30例、替比夫定組79例、對(duì)照組44例。替諾福韋組孕婦口服替諾福韋300 mg/次,1次/d,服藥直至分娩;替比夫定組孕婦口服替比夫定600 mg/次,1次/d,服藥直至分娩;對(duì)照組孕婦不給予治療。各組嬰兒出生后立即注射100 IU乙肝免疫球蛋白,并按照免疫規(guī)劃程序注射乙肝疫苗。在服藥前、服藥第6周、分娩前,檢測(cè)各組孕婦血清HBV DNA、ALT、Cr水平。比較三組患者分娩嬰兒的性別、身高、體質(zhì)量。在嬰兒出生時(shí)、出生7個(gè)月、出生12個(gè)月,觀察血清HBV DNA≥100 IU/m L及HBs Ag、HBe Ag陽(yáng)性例數(shù)。記錄母嬰不良反應(yīng)發(fā)生情況。結(jié)果在服藥第6周、分娩前,替諾福韋組、替比夫定組孕婦血清HBV DNA、ALT水平較本組服藥前、對(duì)照組同時(shí)間點(diǎn)低(P均0.05),且替諾福韋組較替比夫定組低(P均0.05),但三組孕婦血清Cr水平比較差異無(wú)統(tǒng)計(jì)學(xué)意義。三組患者分娩嬰兒的性別、身高、體質(zhì)量比較差異無(wú)統(tǒng)計(jì)學(xué)意義。在嬰兒出生時(shí)、出生7個(gè)月、出生12個(gè)月,替諾福韋組、替比夫定組嬰兒血清HBs Ag、HBe Ag陽(yáng)性例數(shù)和HBV DNA≥100 IU/m L例數(shù)低于對(duì)照組(P均0.05),但兩組比較差異無(wú)統(tǒng)計(jì)學(xué)意義。三組母嬰未見(jiàn)明顯不良反應(yīng)。結(jié)論替諾福韋、替比夫定妊娠期口服均可降低HBV感染孕婦血清HBV DNA水平,并可改善孕婦的肝功能,且前者效果優(yōu)于后者;兩者均可提高HBV母嬰傳播阻斷率,且效果相似。
[Abstract]:Objective to compare the efficacy and safety of tenofovir and tibivudine in preventing mother-to-child transmission of hepatitis B virus (HBV) during pregnancy. Methods 153 pregnant women with HBV infection, including 30 cases of tenofovir group, 79 cases of tibivudine group and 44 cases of control group. The pregnant women in tenofovir group received tenofovir 300 mg/, once a day, until delivery, and in tibivudine group, tibivudine 600 mg/, once a day, until delivery; in control group, no treatment was given to pregnant women. The infants in each group were injected with 100 IU hepatitis B immunoglobulin immediately after birth and vaccinated with hepatitis B vaccine according to the immunization planning procedure. Serum HBV DNA,ALT,Cr levels were measured before administration, 6 weeks after administration and before delivery. The sex, height and body mass of the delivery infants were compared among the three groups. Serum HBV DNA 鈮，

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