摘要
目的探究替诺福韦(TDF)治疗高载量乙肝病毒(HBV)感染孕妇对阻断母婴传播的效果及安全性。方法将我院2016年5月至2020年7月接收的52例高载量HBV感染孕妇纳为研究对象,依据是否接受TDF治疗将其分为常规组(26例,未接受TDF治疗)和研究组(26例,接受TDF治疗),两组新生儿出生后均予以标准免疫预防[乙型肝炎人Ig(HBIG)+乙型肝炎疫苗]。比较两组孕妇HBV-DNA载量变化及母婴阻断效果[新生儿乙肝表面抗原(HBsAg)、HBV-DNA阳性率],观察两组孕妇用药不良反应及新生儿围生期不良事件发生情况。结果治疗后,研究组孕妇HBV-DNA载量低于常规组;研究组新生儿HBsAg、HBV-DNA阳性率均低于常规组,其母婴阻断率高于常规组(P<0.05);研究组孕妇用药不良反应发生率与常规组对比,差异无统计学意义(P>0.05);研究组新生儿围生期不良事件发生率低于常规组(P<0.05)。结论TDF治疗高载量HBV感染孕妇可明显降低母体外周血清HBV-DNA水平,有效阻断母婴传播,且不会导致孕妇发生过多药物不良反应或对新生儿产生过多不良影响,整体安全性较好。
Objective To explore the effect and safety of tenofovir(TDF)on blocking mother-to-child transmission in pregnant women with high-load hepatitis B virus(HBV)infection.Methods 52 cases of high-load HBV-infected pregnant women received in our hospital from May 2016 to July 2020 were included as the research subjects.According to whether they received TDF treatment or not,they were divided into conventional groups(26 cases,not receiving TDF treatment)and the study group(26 cases,received TDF treatment),both groups of newborns received standard immunization prevention after birth[hepatitis B human Ig(HBIG)+hepatitis B vaccine].We compared the changes of HBV-DNA load and maternal-infant blocking effect between the two groups of pregnant women[neonatal hepatitis B surface antigen(HBsAg),HBV-DNA positive rate],observed the adverse reactions of the two groups of pregnant women and perinatal adverse events.Results After treatment,the HBV-DNA load of pregnant women in the study group was lower than that in the routine group;the positive rates of HBsAg and HBVDNA in the study group were lower than those in the routine group,and the maternal and infant blocking rate was higher than that in the routine group(P<0.05).The incidence of adverse drug reactions between pregnant women in the study group and the routine group was not statistically significant(P>0.05).The incidence of neonatal adverse events in the study group was lower than that in the routine group(P<0.05).Conclusion TDF treatment of pregnant women with high-load HBV infection can significantly reduce maternal peripheral serum HBV-DNA levels,effectively block mother-to-child transmission,and will not cause too many adverse drug reactions or excessive adverse effects on newborns.The treatment security is better.
作者
叶志明
高东奔
袁锐坤
宋茂舟
张东常
于海华
YE Zhi-ming;GAO Dong-ben;YUAN Rui-kun;SONG Mao-zhou;ZHANG Dong-chang;YU Hai-hua(Department of Infectious Diseases,Dongguan East Central Hospital,Dongguan,Guangdong 523000;Department of Gastroenterology,Dongguan East Central Hospital,Dongguan,Guangdong 523000)
出处
《智慧健康》
2021年第7期123-125,共3页
Smart Healthcare
基金
2020年东莞市社会科技发展一般项目立项,编号:202050715035704
关键词
乙肝病毒感染
高载量
TDF
母婴阻断
乙型肝炎疫苗
胎膜早破
Hepatitis B virus infection
High load
TDF
Mother-to-child blockade
Hepatitis B vaccine
Premature rupture of membranes
作者简介
叶志明(1986-),男,广东东莞,本科,主治医师,主要从事感染科相关的工作。
