临床肝胆病杂志2013，Vol.29Issue(2)：101-103,3.
替比夫定治疗妊娠晚期慢性乙型肝炎孕妇的临床观察
Clinical trial of telbivudine in the treatment of chronic hepatitis B in patients during the third trimester of pregnancy
摘要
Abstract
Objective To investigate the significance of telbivudine ( LdT) in controlling hepatitis activity and blocking mother - to - infant transmission of hepatitis B virus ( HBV) in women with chronic hepatitis B (CHB) during late pregnancy. Methods A total of 116 pregnant women were enrolled. Each was positive for hepatitis B surface antigen (HBsAg) , hepatitis Be- antigen ( HBeAg) and hepatitis B core antibody ( anti -HBc). They all also had HBV DNA levels of ^105 copies/ml and alanine amino transferase (ALT) levels of 3=2 x ULN, with or without total bilirubin (TBil) increase. They were divided into two groups based upon their personal preference, the treatment group ( n = 65 ) and control group ( n = 51). The patients in the treatment group were (28 ± 2) weeks pregnant and received LdT 600 mg once daily in addition to liver - protecting and enzyme - reducing treatments, while the patients in the control group received only the standard liver - protecting and enzyme - reducing treatment. All infants delivered by the participants received both active and passive immunization after birth. The women in the two groups were compared in terms of the HBV DNA, ALT and TBIL levels before delivery and at 7 months after delivery; positive rates of HBsAg and hepatitis B surface antibody (anti - HBs) were compared in the infants in both groups at 7 months after birth. Furthermore, maternal and neonatal complications were observed. Results The levels of serum HBV DNA, ALT and TBIL in the treatment group were significantly lower than those in the control group before delivery and at 7 months after delivery (P < 0.05). At 7 months after birth, the infants in the treatment group had a significantly lower positive rate for HBsAg (1.5 % vs. 15.7%, P < 0. 05 ) and a significantly higher anti - HBs - positive rate (95. 4% vs. 78. 4% , P < 0. 05 ) compared with those in the control group. Maternal and neonatal complications occurred significantly less frequently in the treatment group than in the control group. Conclusion LdT is effective in controlling hepatitis activity in pregnant women with CHB, as it rapidly decreases HBV DNA levels and reduces mother - to — infant transmission of HBV. Its use is therefore beneficial to both mothers and infants.关键词
替比夫定/肝炎,乙型,慢性/妊娠/疾病传播,垂直Key words
telbivudine/ hepatitis B, chronic/ pregnancy/ disease transmission, vereical分类
医药卫生引用本文复制引用
姜秀浓,范玲燕,李德周,万炯,叶菁菁..替比夫定治疗妊娠晚期慢性乙型肝炎孕妇的临床观察[J].临床肝胆病杂志,2013,29(2):101-103,3.基金项目
宁波市社会发展项目基金(2010C50034) （2010C50034）
