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目的:评价替比夫定对妊娠期孕妇慢性乙肝的临床疗效及其对乙肝病毒(HBV)阻断作用的影响。方法:选取医院2014年8月—2016年8月期间收治的妊娠期慢性乙肝孕妇100例,将其随机分为观察组(48例)与对照组(52例);观察组患者给予替比夫定抗病毒治疗,对照组患者不给予抗病毒治疗,比较两组孕妇给药后的临床疗效和对HBV阻断作用,以及给予两组孕妇娩出的新生儿主动、被动联合免疫治疗。结果:治疗前两组患者的谷丙转氨酶(ALT)、乙肝病毒-DNA(HBV-DNA)测得值经比较其差异无统计学意义(P>0.05);分娩前观察组患者的ALT、HBV-DNA测得值低于对照组(P<0.05),HBs Ab阳性率、HBV母婴阻断成功率明显高于对照组(P<0.05),HBs Ag阳性率、HBV-DNA阳性率低于对照组(P<0.05);两组患者娩出新生儿的胎龄、出生体质量和安全Apgar评分值经比较其差异无统计学意义(P>0.05),也未发生胎儿窘迫症、发育异常和畸形等情况。结论:替比夫定对妊娠期孕妇慢性乙肝的临床疗效较好,可有效地阻断母-婴HBV垂直传播。
Objective: To evaluate the clinical efficacy of telbivudine on pregnant women with chronic hepatitis B during pregnancy and its effect on the blockade of hepatitis B virus (HBV). Methods: One hundred pregnant women with chronic hepatitis B during pregnancy were selected from August 2014 to August 2016 in our hospital. They were randomly divided into observation group (48 cases) and control group (52 cases). Patients in observation group were given Tibif Given antiviral therapy, patients in the control group were not given antiviral therapy. The clinical efficacy and HBV blockade were compared between the two groups, and the active and passive immunotherapy of newborns was given to the two groups of pregnant women. Results: There was no significant difference between the two groups before treatment (ALT) and HBV-DNA (P> 0.05). ALT, HBV (P <0.05). The positive rate of HBs Ab and the success rate of HBV maternal and infant block were significantly higher than those of the control group (P <0.05). The positive rates of HBs Ag and the positive rates of HBV DNA were lower than those of the control group (P <0.05). There was no significant difference in gestational age, birth weight and safe Apgar score between the two groups (P> 0.05), fetal distress syndrome, dysplasia and Deformity and so on. Conclusion: Telbivudine has a good clinical effect on pregnant women with chronic hepatitis B during pregnancy, which can effectively block the vertical transmission of HBV between mother and baby.