替比夫定阻断乙肝病毒母婴传播疗效和安全性探讨.docVIP

替比夫定阻断乙肝病毒母婴传播疗效和安全性探讨 　　[摘要] 目的 探讨替比夫定阻断乙肝病毒（HBV） 母婴传播的疗效及安全性。方法 方便选择2000年1月―2017年1月期间在该院就诊且分娩的乙肝产妇438例，其中338例HBsAg 和 HBeAg 双阳性及 HBV-DNA均大于5.0×104 IU/mL作为研究对象，妊娠期使用替比夫定治疗135例，未使用抗病毒药物者203例，评估婴儿HBV感染情况，并评估治疗安全性。结果 出生后第7～12个月，测新生儿乙肝两对半、HBV-DNA。未抗病毒治疗组HBsAg阳性率（3.44%）、HBV DNA阳性率（2.95%）均显著高于使用替比夫定抗病毒组（0.00%，0.00%），组间差异有统计学意义（P0.05）。抗病毒治疗组与未抗病毒治疗组新生儿出生缺陷肌出生后生长发育无显著区别。结论 替比夫定阻断乙肝病毒母婴传播安全、可靠，未增加不良反应风险。 　　[关键词] 替比夫定； 乙型肝炎病毒； 母婴传播；临床疗效； 安全性 　　[中图分类号] R4 [文献标识码] A [文章编号] 1674-0742（2018）01（b）-0134-03 　　[Abstract] Objective To study the curative effect and safety of telbivudine in blocking the maternal-neonatal transmission of hepatitis B virus. Methods 438 cases of delivery women with hepatitis B virus diagnosed and delivered in our hospital from January 2000 to January 2017 were convenient selected， including the 338 cases with positive HBsAg and HBeAg and whose HBV-DNA was more than 5.0×104 IU/mL， during the pregnancy， there were 135 cases treated with telbivudine and 203 cases without using the antiviral drugs， and the HBV infection of infants and treatment safety were evaluated. Results The hepatitis B two fifty-fifty and HBV-DNA of newborns were measured in 7～12 months after birth， and the HBsAg positive rate and HBV DNA positive rate of patients with non-antiviral therapy were obviously higher than that of patients using the telbivudine anti-viral group， （3.44%， 2.95% vs 0.00%，0.00%）， and the differences were statistically significant（P0.05）， and the difference in the growth and development of newborns with birth defect between the two groups was not obvious. Conclusion The telbivudine in blocking the maternal-neonatal transmission of hepatitis B virus is safe and reliable， without increasing the adverse reactions risk. 　　[Key words] Telbivudine； Hepatitis B virus； Maternal-neonatal transmission； Clinical curative effect； Safety 　　乙型病毒性肝炎是我??最常见的肝炎类型，发病率较高。母婴垂直传播是乙肝重要的传播途径，如何阻断母婴之间的HBV传播是临床研究的重点[1-2]。替比夫定是临床常用的抗乙型肝炎病毒药物，是妊娠B级药物，为了总结其阻断乙肝病毒（HBV） 母婴传播的疗效及安全性，该次研究总结了