摘要
Abstract
Objective To evaluate the clinical efficacy of oral acyclovir for genital herpes in third trimester pregnant women and plasma concentration in delivery .Methods Altogether 23 patients of recurrent genital herpes were selected from March 2010 to December 2015. They orally administered acyclovir tablets 0.4g (tid) from gestation 32 to 36 week to the end of delivery.Acyclovir plasma concentration was detected in umbilical venous blood , umbilical artery blood and maternal venous blood sampled after delivery .Results Twenty patients underwent vaginal delivery .One case of malposition and 2 cases of fetal distress were changed to cesarean section .None of pregnant women complained of herpes activity during delivery , and no neonate appeared HSV infection .Plasma concentration of acyclovir in umbilical venous blood, umbilical artery blood and maternal venous blood was 251.38ng/mL, 231.57ng/mL and 430.64ng/mL, respectively. Acyclovir plasma concentration in 60.87%(14/23) of umbilical venous blood , 47.83%(11/23) of umbilical artery blood and 17.39%(4/23) of maternal venous blood samples was less than acyclovir steady-state plasma concentration (180ng/mL).There were no significant correlation between maternal weight and plasma concentration in umbilical venous blood , umbilical artery blood and maternal venous blood (r value was -0.207, 0.130 and 0.164, respectively, P value was 0.381, 0.876 and 0.773, respectively, all P>0.05). There was no correlation between childbirth process and plasma concentration in umbilical venous blood , umbilical artery blood and maternal venous blood (r value was -0.382, 0.264 and 0.139, respectively, P value was 0.076, 0.533 and 0.413, respectively, all P>0.05).Last dose interval was negatively associated with plasma concentration in umbilical venous blood , umbilical artery blood and maternal venous blood (r value was -0.584, -0.624 and -0.613, respectively,P value was 0.003, 0.001 and 0.002, respectively, all P<0.05).Conclusion Oral acyclovir is unable to guarantee effective blood concentration in delivery .More researches are needed for appropriate dosage and administration method .关键词
阿昔洛韦/单纯疱疹病毒/妊娠期/血药浓度Key words
acyclovir/herpes simplex virus/pregnancy/plasma concentration分类
医药卫生
