【摘要】：目的探討HBe Ag陽(yáng)性高病毒載量的孕婦在孕期是否服用替比夫定以及產(chǎn)后不同的停藥時(shí)間對(duì)其肝功能的影響。方法收集2012年1月至2013年12月于首都醫(yī)科大學(xué)附屬北京地壇醫(yī)院生育的HBe Ag陽(yáng)性高病毒載量的妊娠婦女626例,分為替比夫定組(Ld T組,267例)和未用抗病毒藥物組(對(duì)照組,359例);回顧性分析孕中期服用替比夫定與不服抗病毒藥物治療及不同停藥時(shí)間的孕婦血清HBV DNA、產(chǎn)后肝功能的變化。結(jié)果 Ld T組母親服用替比夫定后HBV DNA水平顯著低于對(duì)照組(t=55.2413,P=0.0000),Ld T組孕婦產(chǎn)前HBV DNA500拷貝/ml的例數(shù)顯著高于對(duì)照組(χ2=49.5180,P=0.0000)。兩組母親產(chǎn)后6個(gè)月內(nèi)最高ALT水平差異具有統(tǒng)計(jì)學(xué)意義(Z=-0.021,P=0.9836),對(duì)照組母親產(chǎn)后ALT2×ULN的病例數(shù)比Ld T組多(χ2=9.1562,P=0.002)。產(chǎn)后0~29 d停藥的母親ALT水平和2×ULN的病例數(shù)均高于產(chǎn)后30 d停藥者。結(jié)論替比夫定用于妊娠第3期加強(qiáng)HBV母嬰阻斷可以有效降低母親體內(nèi)HBV DNA水平,替比夫定治療未增加產(chǎn)后ALT升高的風(fēng)險(xiǎn),而產(chǎn)后停藥過(guò)早可能增加ALT升高的風(fēng)險(xiǎn)。
[Abstract]:Objective to investigate the effect of tibivudine on the liver function of pregnant women with HBe Ag positive and high viral load during pregnancy and postpartum withdrawal of tibivudine. Methods from January 2012 to December 2013, a total of 626 pregnant women with high HBe Ag positive viral load were collected from Beijing The Temple of Earth Hospital affiliated to Capital Medical University. The patients were divided into two groups: tibivudine group (Ld T group, 267 cases) and untreated group (control group, 359 cases). The changes of postpartum liver function of pregnant women taking tibivudine, non-antiviral therapy and different withdrawal time were analyzed retrospectively. Results the HBV DNA level of mothers in Ld T group was significantly lower than that in control group (t 55.2413 P0. 0000). The number of prenatal HBV DNA500 copy / ml cases in LdT group was significantly higher than that in control group (蠂 2 + 49.5180% P0. 0000). There was a significant difference in the highest ALT level between the two groups within 6 months postpartum (ZP0. 021). The number of postpartum ALT2 脳 ULN cases in the control group was higher than that in the Ld T group (蠂 2 / 9.1562 / P0. 002). The level of ALT and the number of cases with 2 脳 ULN were higher than those of those who stopped taking drugs at 30 days postpartum. Conclusion tibivudine used in the third trimester of pregnancy can effectively reduce the level of HBV DNA in mother's body. Tibivudine does not increase the risk of postpartum ALT increase, but the risk of increasing ALT may be increased after termination of tibivudine prematurely.
【作者單位】： 首都醫(yī)科大學(xué)附屬北京地壇醫(yī)院婦產(chǎn)科;首都醫(yī)科大學(xué)附屬北京地壇醫(yī)院肝病科;
【分類號(hào)】：R714.251

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