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目的:观察替比夫定阻断5例慢性乙型肝炎病毒感染妊娠妇女母婴HBV垂直传播的疗效和安全性。方法:2007年3月至8月,5例慢性乙型肝炎病毒感染并对婴儿HBV垂直传播有高度危险的妊娠妇女于妊娠28周至分娩后1个月期间服用替比夫定600mg,1次/d。5例妊娠妇女的HBV DNA≥1×107。观察其服药前和分娩前HBV DNA水平、肝功能及不良反应。检测新生儿HBV DNA、HBsAg,观察其发育情况,并发症和进行Apgar评分。结果:5例HBV感染的妊娠妊娠妇女中,4例未检出HBV DNA(<5×102拷贝/ml),1例HBV DNA末降至可检测下限(HBV DNA4.56×103拷贝/ml),5例新生儿发育正常,Apgar评分均为10分,HBV DNA<5×102拷贝/ml,HBsAg呈阴性。结论:替比夫定似对阻断母婴HBV垂直传播有效,且不影响婴儿的正常发育。
OBJECTIVE: To observe the efficacy and safety of telbivudine in blocking the vertical transmission of HBV in pregnant women and their mothers infected by 5 chronic hepatitis B virus. METHODS: From March to August 2007, 5 pregnant women with chronic hepatitis B virus infection and high risk of vertical transmission of HBV were treated with telbivudine 600 mg once daily for 28 weeks to one month after delivery. d. 5 cases of pregnant women with HBV DNA ≥ 1 × 107. Observe the HBV DNA level, liver function and adverse reactions before administration and before delivery. Detection of neonatal HBV DNA, HBsAg, observation of its development, complications and Apgar score. Results: HBV DNA (5 × 102 copies / ml) was not detected in 4 cases of pregnant women with HBV infection, and one case of HBV DNA dropped to the lower limit of detection (HBV DNA was 4.56 × 103 copies / ml) , 5 newborns developed normally, Apgar scores were 10 points, HBV DNA <5 × 102 copies / ml, HBsAg was negative. Conclusion: Telbivudine seems to be effective in blocking the vertical transmission of maternal and infant HBV, and does not affect the normal development of infants.