【摘要】：目的評價妊娠晚期孕婦口服阿昔洛韋治療生殖器皰疹的臨床療效和分娩期血藥濃度。方法選擇2010年3月至2015年12月上海市公共衛(wèi)生臨床中心就診的復(fù)發(fā)性生殖器皰疹23例,從孕期32~36w起口服阿昔洛韋片0.4g/次,3次/d,療程至分娩結(jié)束,胎兒娩出后抽取臍靜脈血、臍動脈血和母體靜脈血檢測阿昔洛韋血藥濃度。結(jié)果 20例患者陰道順產(chǎn),1例胎位不正和2例胎兒宮內(nèi)窘迫改為剖宮產(chǎn),無1例患者分娩期出現(xiàn)皰疹活動,也無1例新生兒發(fā)生HSV感染。臍靜脈血阿昔洛韋血藥濃度濃度為251.38ng/m L,臍動脈血為231.57ng/m L,母體靜脈血藥濃度為430.64ng/m L;有60.87%(14/23)的臍靜脈血,47.83%(11/23)臍動脈血和17.39%(4/23)母體靜脈血樣本低于阿昔洛韋穩(wěn)態(tài)血藥濃度180ng/m L;母體體重與臍靜脈血、臍動脈血和母體靜脈血血藥濃度均無明顯相關(guān)(r值分別為-0.207、0.130、0.164,P值分別為0.381、0.876、0.773,均P0.05);分娩時程與臍靜脈血、臍動脈血和母體靜脈血血藥濃度也無相關(guān)性(r值分別為-0.382、0.264、0.139,P值分別為0.076、0.533、0.413,均P0.05);末次服藥間隔時間與臍靜脈血、臍動脈血和母體靜脈血血藥濃度均呈負(fù)相關(guān)(r值分別為-0.584、-0.624、-0.613,P值分別為0.003、0.001、0.002,均P0.05)。結(jié)論口服阿昔洛韋無法保證分娩期有效的血藥濃度,而合適的給藥方法和劑量仍需要大量研究。
[Abstract]:Objective to evaluate the efficacy of oral acyclovir in the treatment of genital herpes in late pregnancy. Methods from March 2010 to December 2015, 23 patients with recurrent genital herpes were selected from Shanghai Public Health Clinical Center. Acyclovir tablets were given orally for 3 times a day from 32 days to 36 weeks during pregnancy. The course of treatment was until the end of delivery. Umbilical vein blood, umbilical artery blood and maternal vein blood were collected after delivery. The blood concentration of acyclovir was detected. Results there were 20 cases of vaginal abortion, 1 case of misposition and 2 cases of fetal distress converted to cesarean section. No one patient had herpes activity during delivery, and no newborn had HSV infection. The concentration of acyclovir in umbilical vein blood was 251.38ng/m L, umbilical artery blood was 231.57ng/m L, maternal vein blood concentration was 430.64ng/m L. There were 60.87% (14 / 23) umbilical vein blood samples, 47.83% (11 / 23) umbilical artery blood samples and 17.39% (4 / 23) maternal venous blood samples which were lower than the steady-state 180ng/m concentration of acyclovir. There was no significant correlation between maternal body weight and umbilical vein blood, umbilical artery blood and maternal vein blood concentration (r = -0.207, 0.130, 0.164, P = 0.381U, 0.876n, 0.773respectively, P0.05). There was no correlation between delivery time and umbilical vein blood, umbilical artery blood and maternal vein blood concentration (r = -0.382 ~ 0.264 ~ 0.264 ~ (0.139) P = 0.076 ~ 0.533 ~ 0.413, respectively, P0.05). There was a negative correlation between the interval time of the last medication and the blood concentration of umbilical vein, umbilical artery and maternal vein (r = -0.584- 0.624 ~ -0.613) P = 0.003 ~ 0.001 / 0. 002, respectively (P0.05). Conclusion Oral acyclovir can not guarantee the effective blood concentration during labor, but the proper administration method and dosage still need a lot of research.
【作者單位】： 上海市公共衛(wèi)生臨床中心;
【分類號】：R714.259

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