本文選題：乙肝病毒 + 妊娠��； 參考：《重慶醫(yī)科大學(xué)》2014年碩士論文

【摘要】：乙肝病毒（Hepatitis B virus，HBV）感染一直是威脅人類健康及生命的重要病因，全球大約有4億名乙肝病毒感染者，其中50%的患者是通過母嬰垂直傳播（Mother to infant vertical transmission, MTVT）被感染，他們當(dāng)中超過95%將轉(zhuǎn)為慢性乙型病毒性病毒肝炎（Chronic hepatitis B，CHB）。而同時乙肝病毒感染對妊娠的結(jié)局有不良影響（如：妊娠期糖尿病、產(chǎn)前出血、早產(chǎn)、低體重兒等）。對妊娠合并乙肝病毒感染進行全面認識及有效治療，能顯著降低乙肝病毒感染率及妊娠不良結(jié)局發(fā)生率。 乙肝表面抗原（Hepatitis B surface antigen，HBsAg）陽性的孕婦若有較高乙肝病毒基因（Hepatitis B virus Deoxyribonucleic acid，HBV-DNA）水平及肝炎活動［丙氨酸氨基轉(zhuǎn)移酶（Alanine aminotransferase，ALT）2倍正常上限, HBV-DNA105copies/ml)］或伴有嚴(yán)重程度肝纖維化/肝硬化，建議妊娠早期進行抗病毒治療［1］。在孕28周-30周對乙肝病毒滴度較高（HBV-DNA107copies/ml）孕婦，或既往有HBsAg陽性嬰兒分娩史且HBV-DNA106copies/ml的孕婦，，進行抗病毒治療直到分娩后4周，再根據(jù)病情決定是否繼續(xù)抗病毒治療。新生兒出生后24小時內(nèi)應(yīng)注射高效價乙肝免疫球蛋白（Hepatitis B immune globulin，HBIG）并接種乙肝疫苗，是阻斷母嬰垂直傳播最有效的方式。乙肝病毒感染不能作為選擇性剖宮產(chǎn)的主要因素。在沒有乳頭破裂、出血的孕婦，建議對接受聯(lián)合免疫的新生兒進行母乳喂養(yǎng)。 對于妊娠合并乙肝病毒感染仍有較多有待解決的疑問，如：乙肝病毒是否可以通過父系生殖細胞進行傳播、孕早期抗病毒治療是否安全、孕晚期使用高效價乙肝免疫球蛋白是否能阻斷宮內(nèi)感染等。
[Abstract]:Hepatitis B virus (HBV) infection has been an important cause of human health and life. There are about 400 million people infected with hepatitis B virus, 50% of whom are infected through vertical transmission from mother to child. More than 95 percent of them will be converted to chronic viral hepatitis B virus Chronic hepatitis. At the same time hepatitis B virus infection has adverse effects on the outcome of pregnancy (e.g. gestational diabetes mellitus, prenatal hemorrhage, premature delivery, low birth weight, etc. Comprehensive understanding and effective treatment of pregnancy complicated with hepatitis B virus infection, Hepatitis B surface antigen-HBV-DNA and hepatitis B virus deoxyribonucleic acid nucleic acid DNA (HBV-DNA) level and hepatitis B aminotransferase activity in pregnant women with hepatitis B surface antigen-HBsAg positive were significantly decreased in the presence of hepatitis B virus deoxyribonucleic acid nucleic acid (HBV-DNA) and the activity of hepatitis B aminotransferase (Alanine). Aminotransferase2 times the normal upper limit, HBV-DNA 105 cases / ml] or severe liver fibrosis / cirrhosis, It is recommended that antiviral therapy be carried out in early pregnancy [1]. From 28 weeks to 30 weeks of gestation, pregnant women with high HBV titer (HBV-DNA 107copias / ml), or pregnant women with HBsAg positive infant delivery history and HBV-DNA 106copias / ml, were treated with antiviral therapy until 4 weeks after delivery, and then decided whether to continue antiviral therapy according to their condition. It is the most effective way to block vertical transmission from mother to child by injecting high titer hepatitis B immune globulin (HBIGI) and inoculating hepatitis B vaccine within 24 hours after birth. Hepatitis B virus infection is not a major factor in selective cesarean section. In pregnant women without ruptured nipples and bleeding, breast-feeding of newborns receiving combined immunization is recommended. There are still more questions to be solved about pregnancy with hepatitis B virus infection. Such as: whether hepatitis B virus can be transmitted through paternal germ cells, whether antiviral therapy is safe in early pregnancy and whether high titer hepatitis B immunoglobulin can block intrauterine infection in the third trimester of pregnancy.
【學(xué)位授予單位】：重慶醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2014
【分類號】：R714.251

【參考文獻】

相關(guān)期刊論文 前10條

1 龐麗紅;黃海霞;黃星;;妊娠晚期注射乙肝免疫球蛋白對阻斷乙肝病毒母嬰傳播的效果[J];廣西醫(yī)科大學(xué)學(xué)報;2013年02期

2 羅慧琴;王志剛;李玲;劉付芹;;乙肝產(chǎn)婦HBV-DNA載量與母嬰垂直傳播之間關(guān)系的研究[J];國際檢驗醫(yī)學(xué)雜志;2013年19期

3 楊松;邢卉春;成軍;;《歐洲肝臟病學(xué)會慢性HBV感染臨床管理指南》解讀[J];中國肝臟病雜志(電子版);2012年02期

4 肖艷春;;乙型肝炎病毒父嬰垂直傳播的臨床分析[J];臨床合理用藥雜志;2013年34期

5 魏俊妮;王素萍;;乙型肝炎病毒宮內(nèi)感染危險因素的系統(tǒng)評價[J];衛(wèi)生研究;2008年06期

6 朱明宇;;8693例孕產(chǎn)婦乙型肝炎病毒感染檢測分析[J];寧夏醫(yī)學(xué)院學(xué)報;2008年04期

7 方芳;劉敏;蔡fg東;曹彥君;;妊娠早期核苷(酸)類藥物暴露后妊娠失敗的觀察[J];藥物不良反應(yīng)雜志;2012年02期

8 倪明軍;鄧少芳;廖再成;蔡江慧;鐘婉秀;黃粉珍;;不同孕期注射乙肝免疫球蛋白對HBV宮內(nèi)傳播的阻斷作用[J];中國婦幼保健;2007年11期

9 ;A meta-analysis of lamivudine for interruption of mother-to-child transmission of hepatitis B virus[J];World Journal of Gastroenterology;2011年38期

10 孟慶舉;肖小敏;;產(chǎn)前乙型肝炎病毒父嬰垂直傳播幾率的Meta分析[J];中國優(yōu)生與遺傳雜志;2008年05期

本文編號：1999360