阿昔洛韦口服治疗晚期妊娠生殖器疱疹的血药浓度和疗效评价

发布时间：2018-11-22 13:19

【摘要】：目的评价妊娠晚期孕妇口服阿昔洛韦治疗生殖器疱疹的临床疗效和分娩期血药浓度。方法选择2010年3月至2015年12月上海市公共卫生临床中心就诊的复发性生殖器疱疹23例,从孕期32~36w起口服阿昔洛韦片0.4g/次,3次/d,疗程至分娩结束,胎儿娩出后抽取脐静脉血、脐动脉血和母体静脉血检测阿昔洛韦血药浓度。结果 20例患者阴道顺产,1例胎位不正和2例胎儿宫内窘迫改为剖宫产,无1例患者分娩期出现疱疹活动,也无1例新生儿发生HSV感染。脐静脉血阿昔洛韦血药浓度浓度为251.38ng/m L,脐动脉血为231.57ng/m L,母体静脉血药浓度为430.64ng/m L;有60.87%(14/23)的脐静脉血,47.83%(11/23)脐动脉血和17.39%(4/23)母体静脉血样本低于阿昔洛韦稳态血药浓度180ng/m L;母体体重与脐静脉血、脐动脉血和母体静脉血血药浓度均无明显相关(r值分别为-0.207、0.130、0.164,P值分别为0.381、0.876、0.773,均P0.05);分娩时程与脐静脉血、脐动脉血和母体静脉血血药浓度也无相关性(r值分别为-0.382、0.264、0.139,P值分别为0.076、0.533、0.413,均P0.05);末次服药间隔时间与脐静脉血、脐动脉血和母体静脉血血药浓度均呈负相关(r值分别为-0.584、-0.624、-0.613,P值分别为0.003、0.001、0.002,均P0.05)。结论口服阿昔洛韦无法保证分娩期有效的血药浓度,而合适的给药方法和剂量仍需要大量研究。
[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.
【作者单位】：上海市公共卫生临床中心;
【分类号】：R714.259

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