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目的临床观察拉米夫定干预下慢性乙型肝炎孕妇的病毒动态及安全性。方法对拉米夫定治疗中发现早孕而继续服药的18例慢性乙型肝炎孕妇及发现早孕而停止服药的22例乙型肝炎孕妇,分别观察其病毒动态、妊娠并发症、婴幼儿HBV感染率及发育异常发生率。结果18例继续服用拉米夫定治疗的慢性乙型肝炎孕妇中16例HBV-DNA阴性,18例孕妇所产婴儿HBV感染率为零,妊娠并发症为零,尚未发现婴幼儿发育异常情况。而停止服药的22例慢性乙型肝炎孕妇中,19例HBV-DNA阳性。其婴儿HBV感染率41.9%,有17例发生妊娠并发症。结论拉米夫定可有效降低孕妇HBV-DNA水平,有助于阻断母婴传播,也有助于降低乙型肝炎妊娠并发症。
Objective To observe the virus dynamics and safety of pregnant women with chronic hepatitis B under lamivudine intervention. Methods Twenty-eight pregnant women with chronic hepatitis B who were diagnosed with early pregnancy and who continued to take medicine during the first trimester of pregnancy and 22 pregnant women with hepatitis B who stopped early medication during the first trimester of pregnancy were observed. The incidence of HBV infection, pregnancy complications, And the incidence of dysplasia. Results Of the 18 pregnant women with chronic hepatitis B treated with lamivudine, 16 were HBV-DNA negative. The infection rate of infants in 18 pregnant women was zero and the pregnancy complication was zero. No abnormal development in infants was found. Of the 22 patients with chronic hepatitis B who stopped taking medicine, 19 were HBV-DNA positive. The infant HBV infection rate of 41.9%, 17 cases of pregnancy complications. Conclusion Lamivudine can effectively reduce HBV-DNA levels in pregnant women, help to block the transmission of mother-to-infant, and also reduce the complications of hepatitis B pregnancy.