CAJ | 학술논문

目的：探讨在妊娠晚期应用替比夫定阻断乙型肝炎病毒母婴传播的临床疗效和安全性。方法应用计算机检索中国生物医学文献数据库、万方医学数据库、中文科技期刊数据库、中国知网、PubMed、ISI web of knowledge、EMbase、Cochrane Library、BIOSIS Previews 等数据库，截止日期为2013年9月。参照纳入和排除标准进行文献筛选，采用 RevMan5.1软件进行Meta 分析。结果纳入文献11篇，共1241例孕妇，其中应用替比夫定602例，对照组639例；Meta 分析结果显示，随访6～12月龄婴儿，替比夫定组 HBsAg 和 HBV DNA 阳性率均低于对照组，差异有统计学意义[RR=0.15，95%CI（0.08，0.28），P＜0.00001；RR=0.12，95%CI（0.05，0.32），P＜0.0001]；替比夫定组孕妇分娩前 HBV DNA 水平低于对照组，差异有统计学意义[MD=-3.86，95%CI（-4.55，-3.16），P＜0.00001]；替比夫定组肌酸激酶升高率高于对照组，差异有统计学意义[MD=-3.86，95%CI（-4.55，-3.16），P＜0.00001]，应用替比夫定孕妇所产新生儿无畸形等并发症发生。结论替比夫定能阻断 HBV 宫内感染，其应用安全、有效。
목적：탐토재임신만기응용체비부정조단을형간염병독모영전파적림상료효화안전성。방법응용계산궤검색중국생물의학문헌수거고、만방의학수거고、중문과기기간수거고、중국지망、PubMed、ISI web of knowledge、EMbase、Cochrane Library、BIOSIS Previews 등수거고，절지일기위2013년9월。삼조납입화배제표준진행문헌사선，채용 RevMan5.1연건진행Meta 분석。결과납입문헌11편，공1241례잉부，기중응용체비부정602례，대조조639례；Meta 분석결과현시，수방6～12월령영인，체비부정조 HBsAg 화 HBV DNA 양성솔균저우대조조，차이유통계학의의[RR=0.15，95%CI（0.08，0.28），P＜0.00001；RR=0.12，95%CI（0.05，0.32），P＜0.0001]；체비부정조잉부분면전 HBV DNA 수평저우대조조，차이유통계학의의[MD=-3.86，95%CI（-4.55，-3.16），P＜0.00001]；체비부정조기산격매승고솔고우대조조，차이유통계학의의[MD=-3.86，95%CI（-4.55，-3.16），P＜0.00001]，응용체비부정잉부소산신생인무기형등병발증발생。결론체비부정능조단 HBV 궁내감염，기응용안전、유효。
Objective To systematically review the efficacy and safety of telbivudine in preventing moth-er-to-infant transmission of hepatitis B virus in the third trimester of pregnancy. Methods Chinese Biomedical Literature Database,WanFang Database Online,Chinese Scientific Journals Database,CNKI,PubMed,ISI web of knowledge,EMBASE,Cochrane Library and BIOSIS Previews were searched for related articles till September 2013. Two reviewers independently screened these articles according to inclusion and exclusion criterion. Meta-analysis was performed by using software Rvman 5.1. Results Eleven papers were included in this study,with a total of 1241 pregnant women,including 602 cases received telbivudine and 639 cases of control;Meta-analysis showed that, after a 6 to 12 month of follow-up,the seropositive rates for HBsAg and HBV DNA in babies of telbivu-dine-treated mothers were significantly lower than in babies of non-treated mothers [RR=0.15,95%CI(0.08,0.28), P<0.00001;RR=0.12,95%CI (0.05,0.32),P<0.0001,respectively];Maternal HBV DNA levels prior to delivery was significantly lower in telbivudine-treated women than in non-treated women[MD=-3.86,95%CI(-4.55,-3.16),P<0.00001];The rate of elevation in serum creatine kinase(CK) was significantly higher in telbivudine-treated moth-ers than in non-treated mothers [MD=-3.86,95%CI (-4.55,-3.16),P<0.00001];The neonates in telbivudine group were born without deformity and other complications. Conclusion Telbivudine is effective and safe in blocking HBV intrauterine infection.