孕期服用替比夫定进行乙型肝炎母婴阻断的产后肝功能观察

发布时间：2018-09-05 20:22

【摘要】：目的探讨HBe Ag阳性高病毒载量的孕妇在孕期是否服用替比夫定以及产后不同的停药时间对其肝功能的影响。方法收集2012年1月至2013年12月于首都医科大学附属北京地坛医院生育的HBe Ag阳性高病毒载量的妊娠妇女626例,分为替比夫定组(Ld T组,267例)和未用抗病毒药物组(对照组,359例);回顾性分析孕中期服用替比夫定与不服抗病毒药物治疗及不同停药时间的孕妇血清HBV DNA、产后肝功能的变化。结果 Ld T组母亲服用替比夫定后HBV DNA水平显著低于对照组(t=55.2413,P=0.0000),Ld T组孕妇产前HBV DNA500拷贝/ml的例数显著高于对照组(χ2=49.5180,P=0.0000)。两组母亲产后6个月内最高ALT水平差异具有统计学意义(Z=-0.021,P=0.9836),对照组母亲产后ALT2×ULN的病例数比Ld T组多(χ2=9.1562,P=0.002)。产后0~29 d停药的母亲ALT水平和2×ULN的病例数均高于产后30 d停药者。结论替比夫定用于妊娠第3期加强HBV母婴阻断可以有效降低母亲体内HBV DNA水平,替比夫定治疗未增加产后ALT升高的风险,而产后停药过早可能增加ALT升高的风险。
[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.
【作者单位】：首都医科大学附属北京地坛医院妇产科;首都医科大学附属北京地坛医院肝病科;
【分类号】：R714.251

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