替诺福韦、替比夫定妊娠期口服对HBV母婴传播的阻断效果及安全性比较

发布时间：2018-12-17 03:21

【摘要】：目的比较替诺福韦、替比夫定妊娠期口服对乙肝病毒(HBV)母婴传播的阻断效果及安全性。方法153例HBV感染的孕妇,其中替诺福韦组30例、替比夫定组79例、对照组44例。替诺福韦组孕妇口服替诺福韦300 mg/次,1次/d,服药直至分娩;替比夫定组孕妇口服替比夫定600 mg/次,1次/d,服药直至分娩;对照组孕妇不给予治疗。各组婴儿出生后立即注射100 IU乙肝免疫球蛋白,并按照免疫规划程序注射乙肝疫苗。在服药前、服药第6周、分娩前,检测各组孕妇血清HBV DNA、ALT、Cr水平。比较三组患者分娩婴儿的性别、身高、体质量。在婴儿出生时、出生7个月、出生12个月,观察血清HBV DNA≥100 IU/m L及HBs Ag、HBe Ag阳性例数。记录母婴不良反应发生情况。结果在服药第6周、分娩前,替诺福韦组、替比夫定组孕妇血清HBV DNA、ALT水平较本组服药前、对照组同时间点低(P均0.05),且替诺福韦组较替比夫定组低(P均0.05),但三组孕妇血清Cr水平比较差异无统计学意义。三组患者分娩婴儿的性别、身高、体质量比较差异无统计学意义。在婴儿出生时、出生7个月、出生12个月,替诺福韦组、替比夫定组婴儿血清HBs Ag、HBe Ag阳性例数和HBV DNA≥100 IU/m L例数低于对照组(P均0.05),但两组比较差异无统计学意义。三组母婴未见明显不良反应。结论替诺福韦、替比夫定妊娠期口服均可降低HBV感染孕妇血清HBV DNA水平,并可改善孕妇的肝功能,且前者效果优于后者;两者均可提高HBV母婴传播阻断率,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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