现代妇产科进展2025，Vol.34Issue(11)：801-807,7.DOI:10.13283/j.cnki.xdfckjz.2025.11.030
101例乙肝孕妇不同时机抗病毒治疗的疗效与母婴阻断效果分析
Analysis of the efficacy of antiviral treatment at different times and the effect of mater-nal and infant blocking in 101 pregnant women with hepatitis B
摘要
Abstract
Objective:To analyze the efficacy of antiviral treatment in pregnant women with hepatitis B and the effect of mother-to-child blocking of pregnant women with hepatitis B who started antiviral treatment at different times.Methods:A prospective cohort study was used to analyze relevant information on all pregnant women with hepatitis B who delivered in the Third People's Hospital of Kunming City from 2021 to 2023.Pregnant women with high viral load served as the experimental group,and pregnant women with low viral load served as the control group.Pregnant women with high viral loads were divided into different intervention groups for antiviral treatment according to their preferences,and relevant demographic and clini-cal information were collected.The data were analyzed using SPSS 26.0 software.Results:A-mong the 101 pregnant women with hepatitis B,46(45.50%)were pregnant women with high viral load,withanaveragevalueof8.27lgIU/mL;55(54.50%)werepregnantwomenwithlow viral load,with an average value of 4.00lgIU/mL.All 86 infants were tested negative for HBsAg at follow-up,and no one was positive for HBsAg.The mother-to-child transmission rate of the hepatitis B virus was 0%.The mean reduction in viral load during pregnancy in the untreatment group was significantly lower than that in the antiviral treatment group(0.30lgIU/mL vs 3.29 lgIU/mL,P<0.001).The viral load reduction in the<12-week intervention group was signifi-cantly higher than that in the 24～27-week intervention group(5.62lgIU/mL vs 4.05lgIU/mL,P<0.01)and the≥28-week intervention group(5.62lgIU/mL vs 3.87lgIU/mL,P<0.01).The mean birth weight of infants in the mother receiving antiviral treatment group was lower than that in the non-antiviral treatment group(3033.87g vs 3297.42g,P<0.01).The mean birth length of infants in the mother receiving antiviral treatment group was lower than that in the non-antiviral treatment group(49.25cm vs 49.94cm,P=0.02).Low birth weight infants were not related to the mother's antiviral treatment(P=0.17).Conclusion:TDF antiviral treat-ment for pregnant women with hepatitis B during pregnancy is safe and effective.The earlier an-tiviral treatment is started during pregnancy,the more obvious the viral load will decrease.It is recommended to conduct individualized management for pregnant women with HBV DNA levels higher than 8.00lgIU/mL,and appropriately advance antiviral treatment time can reduce prena-tal HBV DNA and reduce the risk of mother-to-child transmission.关键词
慢性乙型肝炎/高病毒载量/母婴阻断/抗病毒治疗/联合免疫Key words
Chronic hepatitis B/High viral load/Mother-to-child blocking/Antiviral therapy/Combined immunization分类
临床医学引用本文复制引用
王洁梅,李玲,张璇,李梅正,李金翠,吴爱辉..101例乙肝孕妇不同时机抗病毒治疗的疗效与母婴阻断效果分析[J].现代妇产科进展,2025,34(11):801-807,7.基金项目
云南省教育厅科学研究基金项目(No:2023J0920) （No:2023J0920）
