论文部分内容阅读
目的探讨拉米夫定不同停药时间对阻断乙型肝炎产妇宫内感染影响的应用效果。方法 100例乙型肝炎宫内感染孕妇,随机分成对照组(25例)和观察组(75例)。对照组未予以药物干预治疗,观察组孕妇在孕28周开始给予拉米夫定药物治疗,根据该组孕妇的停药时间的不同又分为A、B、C三组,各25例。观察记录四组孕妇停药前后谷草转氨酶(AST)肝功能指标、乙肝病毒的脱氧核糖核酸(HBVDNA)定量的变化,并比较四组孕妇新生儿宫内感染的情况。结果四组孕妇停药后1、3、6个月肝功能AST指标总异常率A组最低,明显低于其他三组(P<0.05),对照组高于其他三组(P<0.05),B组与C组的总异常率比较差异无统计学意义(P>0.05)。A、B、C三组孕妇HBV-DNA定量均在停药后1个月恢复到服药前(P<0.05),而对照组无明显变化,差异无统计学意义(P>0.05)。观察组孕妇新生儿宫内感染率均为0,显著低于对照组的16.0%(P<0.05)。结论拉米夫定可有效阻断乙型肝炎产妇宫内感染,对于高病毒载量的孕妇在分娩后即可停药,但需继续定期复查肝功能和HBV-DNA定量。
Objective To investigate the effect of different lamivudine withdrawal time on the intrauterine infection in patients with hepatitis B block. Methods 100 pregnant women with intrauterine infection of hepatitis B were randomly divided into control group (n = 25) and observation group (n = 75). The control group was not treated with drugs. The pregnant women in observation group were given lamivudine at 28 weeks’ gestation. According to the withdrawal time of pregnant women in this group, they were divided into three groups of A, B and C, with 25 cases in each group. The changes of hepatic function of aspartate aminotransferase (AST) and HBV DNA (HBV DNA) in four groups of pregnant women before and after the withdrawal were observed and recorded. The intrauterine infection in the four groups of pregnant women was compared. Results The total abnormal rate of AST of liver function in the three groups at one, three and six months after stopping the treatment was the lowest in group A, significantly lower than the other three groups (P <0.05), the control group was higher than the other three groups (P <0.05) There was no significant difference in the total abnormal rate between group B and group C (P> 0.05). The HBV-DNA levels of pregnant women in groups A, B and C returned to the levels before treatment (P <0.05) one month after treatment, while there was no significant difference in the control group (P> 0.05). The intrauterine infection rate of pregnant women in the observation group was 0, which was significantly lower than that of the control group (16.0%, P <0.05). Conclusion Lamivudine can effectively block intrauterine infection in patients with hepatitis B, and can be stopped after delivery for pregnant women with high viral load. However, the liver function and HBV-DNA quantity should be checked regularly.