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目的 探讨抗病毒药物替诺福韦酯阻断HBV母婴传播的有效性,为更有效地阻断HBV母婴传播提供科学依据.方法 将85例HBsAg阳性孕妇分为观察组50例(愿意接受阻断治疗)和对照组35例(不愿意接受阻断治疗),观察组孕妇分别在第28、32、36周给予300 mg/d替诺福韦酯口服,分别检测两组孕妇28、32、36周及分娩时血清中HBV-DNA载量及新生儿HBV感染率,并对新生儿随访3、6、12个月检测新生儿HBsAg、抗HBs阳性率.结果 观察组孕妇32、36周及分娩时血清中HBV-DNA载量显著低于对照组,新生儿感染率显著低于对照组,差异均有统计学意义(P＜0.05).随访结果显示,观察组新生儿3、6、12个月HBsAg阳性率显著低于对照组,3、6个月抗HBs阳性率则高于对照组,差异均有统计学意义(P＜0.05).结论 替诺福韦酯可以在一定程度上阻断HBV的母婴传播,值得临床鼓励HBV感染孕妇应用.“,”Objective To explore the effectiveness of tenofovir disoproxil fumarate in blocking HBV mother-to-fetus vertical transmission,provide a scientific basis for effective blocking of HBV mother-to-fetus vertical transnnission.Methods Eighty-five pregnant women with positive HBsAg were divided into observation group (50 cases receiving blocking therapy) and control group (35 cases not receiving blocking therapy).The cases in observation group were treated by oral administration of tenofovir disoproxil fumarate (300 mg/d) during the 28th,the 32nd,and the 36th weeks of pregnancy.HBV-DNA loads in serum and HBV infection rates of neonates during the 28th,the 32nd,and the 36th weeks of pregnancy and at birth in the two groups were detected,respectively.The positive rates of HbsAg and anti-HBs among the neonates at 3,6,and 12 months after birth were followed up.Results HBV-DNA loads in serum during the 2nd and the 36th weeks of pregnancy and at birth and HBV infection rate of neonates in observation group were statistically significantly lower than those in control group (P＜0.05).The positive rates of HbsAg among the neonates at 3,6,and 12 months after birth in observation group were statistically significantly lower than those in control group (P＜0.05).The positive rates of anti-HBs among the neonates at 3 and 6 months after birth in observation group were statistically significantly higher than those in control group (P＜0.05).Conclusion Tenofovir disoproxil fumarate can block HBV mother-to-fetus vertical transmission to a certain extent,and it is worthy of clinical application among HBV-infected pregnant women.