目的评价拉米夫定(LAM)和替比夫定(LDT)阻断乙型病毒性肝炎病毒(HBV)母婴传播的疗效及安全性。方法乙型病毒性肝炎病毒表面抗原(HBs Ag)和乙型病毒性肝炎病毒e抗原(HBe Ag)双阳性孕妇36例,按患者意愿分为LAM组16例及LDT组20例,同期未接受抗病毒治疗的HBs Ag和HBe Ag双阳性孕妇22例作为对照组。治疗组自孕28周至分娩后3月口服LAM或LDT,观察各组在孕28周、分娩时和分娩后3个月血清HBV DNA水平及婴儿出生、8月龄血清HBs Ag及HBV DNA的阳性率。结果 LAM及LDT组孕妇分娩及分娩后3个月HBV DNA显著低于对照组(P<0.05);但LAM和LDT组HBV DNA下降差异无统计学意义(分娩时P>0.05;产后3月:P>0.05)。出生及8个月龄LAM、LDT组婴儿HBs Ag和HBV DNA阳性率均显著低于对照组(均P<0.05)。结论 HBs Ag和HBe Ag双阳性孕妇在妊娠晚期服用LAM或LDT均可有效阻断乙肝病毒母婴传播,2种药物疗效差异无统计学意义。 Objective To evaluate the efficacy and safety of lamivudine (LAM) and telbivudine (LDT) in blocking mother-to-child transmission of hepatitis B virus (HBV). Methods Thirty-six HBsAg and HBe Ag positive pregnant women were divided into 16 groups according to the patients’ wishes and 20 patients in the LDT group, which were not accepted in the same period Antiviral treatment of HBsAg and HBeAg double positive pregnant women in 22 cases as a control group. The patients in the treatment group were given oral LAM or LDT orally from 28 weeks after birth to March after delivery. The serum HBV DNA levels at the 28th week of gestation, 3 months after delivery and at 3 months after delivery were observed, and the positive rates of HBsAg and HBV DNA at 8 months rate. Results The HBV DNA levels of pregnant women in LAM and LDT group were significantly lower than those in control group at 3 months after delivery and delivery (P <0.05), but there was no significant difference between LAM and LDT group (P> 0.05 at delivery and 3 months postpartum) P> 0.05). The positive rates of HBs Ag and HBV DNA in infants born at birth and 8 months old were significantly lower than those in control group (all P <0.05). Conclusion HBsAg and HBeAg double positive pregnant women in the third trimester of pregnancy can effectively block the mother-to-child transmission of LAM or LDT, the difference between the two drugs was not statistically significant.