中华传染病杂志
中華傳染病雜誌
중화전염병잡지
CHINESE JOURNAL OF INFECTIOUS DISEASES
2014年
9期
550-553
,共4页
岳欣%韩国荣%张贤%江红秀%和沁园%丁袆
嶽訢%韓國榮%張賢%江紅秀%和沁園%丁袆
악흔%한국영%장현%강홍수%화심완%정위
肝炎e抗原,乙型%肝炎病毒,乙型%疾病传播,垂直
肝炎e抗原,乙型%肝炎病毒,乙型%疾病傳播,垂直
간염e항원,을형%간염병독,을형%질병전파,수직
Hepatitis Beantigens%Hepatitis B virus%Disease transmission,vertical
目的：了解替比夫定治疗 HBeAg 阴性 CHB 孕妇的有效性及安全性。方法将2007年5月至2012年5月62例 HBeAg 阴性 CHB 孕妇，分为替比夫定治疗组（观察组）31例和复方甘草酸苷治疗组31例（对照组），观察组口服替比夫定600 mg/d，对照组静脉滴注复方甘草酸苷120 mg/d。所有新生儿出生即刻及出生后15 d 分别肌内注射高效价乙型肝炎免疫球蛋白（HBIG）200 IU，0、1、6个月肌内注射基因工程乙型肝炎疫苗20μg。检测两组患者血清 ALT、HBV DNA 水平，比较两组 HBV DNA 阴转率、宫内感染发生率、孕期、分娩方式、产后出血、新生儿体质量及是否畸形等。计数资料采用χ2检验，组间比较采用 t 检验。结果观察组在分娩前及产后6周 HBV DNA 分别为（0．20±0．11）和（0．22±0．13）lg 拷贝/mL，与治疗前的（6．24±0．75）lg 拷贝/mL 比较，差异有统计学意义（t 值分别为303．128、301．321，均 P ＜0．01）；观察组分娩前 HBV DNA 转阴28例，而对照组无一例转阴，两组分娩前及产后6周 HBV DNA 比较，差异有统计学意义（t 值分别为-20．285、-8．721，均P ＜0．01）。观察组在分娩前及产后6周 ALT 分别为（13．08±5．87）和（25．97±17．48）U/L，与治疗前（205．95±95．69）U/L比较，差异有统计学意义（t 值分别为93．128、81．321，均 P ＜0．01）；对照组分娩前 ALT 为（104．15±69．15）U/L，与治疗前（209．60±102．24）U/L 比较，差异有统计学意义（t ＝9．281，P ＝0．032），但 ALT 出现反复波动，产后6周 ALT 为（150．26±86．43）U/L，与治疗前比较，差异无统计学意义（t＝2．821，P ＝0．122）。两组分娩前及产后6周 ALT 水平比较，差异有统计学意义（t 值分别为-2．559、-3．158，均 P ＜0．05）。两组孕妇宫内感染发生率、孕期、分娩方式、产后出血、新生儿体质量及畸形等方面比较，均差异无统计学意义。结论HBeAg 阴性 CHB 孕妇采用替比夫定抗病毒治疗可有效控制肝炎活动，降低病毒含量。
目的：瞭解替比伕定治療 HBeAg 陰性 CHB 孕婦的有效性及安全性。方法將2007年5月至2012年5月62例 HBeAg 陰性 CHB 孕婦，分為替比伕定治療組（觀察組）31例和複方甘草痠苷治療組31例（對照組），觀察組口服替比伕定600 mg/d，對照組靜脈滴註複方甘草痠苷120 mg/d。所有新生兒齣生即刻及齣生後15 d 分彆肌內註射高效價乙型肝炎免疫毬蛋白（HBIG）200 IU，0、1、6箇月肌內註射基因工程乙型肝炎疫苗20μg。檢測兩組患者血清 ALT、HBV DNA 水平，比較兩組 HBV DNA 陰轉率、宮內感染髮生率、孕期、分娩方式、產後齣血、新生兒體質量及是否畸形等。計數資料採用χ2檢驗，組間比較採用 t 檢驗。結果觀察組在分娩前及產後6週 HBV DNA 分彆為（0．20±0．11）和（0．22±0．13）lg 拷貝/mL，與治療前的（6．24±0．75）lg 拷貝/mL 比較，差異有統計學意義（t 值分彆為303．128、301．321，均 P ＜0．01）；觀察組分娩前 HBV DNA 轉陰28例，而對照組無一例轉陰，兩組分娩前及產後6週 HBV DNA 比較，差異有統計學意義（t 值分彆為-20．285、-8．721，均P ＜0．01）。觀察組在分娩前及產後6週 ALT 分彆為（13．08±5．87）和（25．97±17．48）U/L，與治療前（205．95±95．69）U/L比較，差異有統計學意義（t 值分彆為93．128、81．321，均 P ＜0．01）；對照組分娩前 ALT 為（104．15±69．15）U/L，與治療前（209．60±102．24）U/L 比較，差異有統計學意義（t ＝9．281，P ＝0．032），但 ALT 齣現反複波動，產後6週 ALT 為（150．26±86．43）U/L，與治療前比較，差異無統計學意義（t＝2．821，P ＝0．122）。兩組分娩前及產後6週 ALT 水平比較，差異有統計學意義（t 值分彆為-2．559、-3．158，均 P ＜0．05）。兩組孕婦宮內感染髮生率、孕期、分娩方式、產後齣血、新生兒體質量及畸形等方麵比較，均差異無統計學意義。結論HBeAg 陰性 CHB 孕婦採用替比伕定抗病毒治療可有效控製肝炎活動，降低病毒含量。
목적：료해체비부정치료 HBeAg 음성 CHB 잉부적유효성급안전성。방법장2007년5월지2012년5월62례 HBeAg 음성 CHB 잉부，분위체비부정치료조（관찰조）31례화복방감초산감치료조31례（대조조），관찰조구복체비부정600 mg/d，대조조정맥적주복방감초산감120 mg/d。소유신생인출생즉각급출생후15 d 분별기내주사고효개을형간염면역구단백（HBIG）200 IU，0、1、6개월기내주사기인공정을형간염역묘20μg。검측량조환자혈청 ALT、HBV DNA 수평，비교량조 HBV DNA 음전솔、궁내감염발생솔、잉기、분면방식、산후출혈、신생인체질량급시부기형등。계수자료채용χ2검험，조간비교채용 t 검험。결과관찰조재분면전급산후6주 HBV DNA 분별위（0．20±0．11）화（0．22±0．13）lg 고패/mL，여치료전적（6．24±0．75）lg 고패/mL 비교，차이유통계학의의（t 치분별위303．128、301．321，균 P ＜0．01）；관찰조분면전 HBV DNA 전음28례，이대조조무일례전음，량조분면전급산후6주 HBV DNA 비교，차이유통계학의의（t 치분별위-20．285、-8．721，균P ＜0．01）。관찰조재분면전급산후6주 ALT 분별위（13．08±5．87）화（25．97±17．48）U/L，여치료전（205．95±95．69）U/L비교，차이유통계학의의（t 치분별위93．128、81．321，균 P ＜0．01）；대조조분면전 ALT 위（104．15±69．15）U/L，여치료전（209．60±102．24）U/L 비교，차이유통계학의의（t ＝9．281，P ＝0．032），단 ALT 출현반복파동，산후6주 ALT 위（150．26±86．43）U/L，여치료전비교，차이무통계학의의（t＝2．821，P ＝0．122）。량조분면전급산후6주 ALT 수평비교，차이유통계학의의（t 치분별위-2．559、-3．158，균 P ＜0．05）。량조잉부궁내감염발생솔、잉기、분면방식、산후출혈、신생인체질량급기형등방면비교，균차이무통계학의의。결론HBeAg 음성 CHB 잉부채용체비부정항병독치료가유효공제간염활동，강저병독함량。
Objective To evaluate the efficacy and safety of telbivudine for pregnant women with hepatitis Be antigen (HBeAg)negative chronic hepatitis B(CHB). Methods Sixty-two cases of HBeAg negative CHB pregnant women were collected from May 2007 to May 2012,and they were divided into telbivudine group (n=31 ,600 mg per day by oral administration)and compound glycyrrhizin group (n=31 ,120 mg per day by intravenous administration).All neonates were given intramuscular injection of 200 IU hepatitis Bimmune globalin at birth immediately and 15 days after birth,and 20 μg genetically engineered hepatitis B vaccine at 0,1 and 6 months after birth.The serum alanine aminotransferase (ALT)level and hepatitis B virus (HBV)DNA titer were monitored.The HBV DNA negative conversion rate,the rate of intrauterine infection,duration of pregnancy,delivery mode,neonate weight and disability rate were compared between groups.All categorical data were analyzed using the chi-square test and comparison between groups was analyzed by t test.Results In telbivudine group,the HBV DNA level before delivery ([0.20±0.11]lg copy/mL)and 6 weeks after delivery ([0.22±0.13]lg copy/mL) were lower than that before treatment [(6.24±0.75 )lg copy/mL]and the differences were statistically significant (t=303.128 and 301 .321 ,respectively;both P <0.01).The negative conversion rate of HBV DNA in telbivudine group was 28 cases before delivery,while in compound glycyrrhizin group,no one had HBV DNA negative conversion.And statistical significant differences were achieved between these two groups before delivery and 6 weeks after delivery (t = -20.285 and -8.721 ,respectively;both P <0.01).In telbivudine group,the ALT levels before delivery and 6 weeks after delivery were (13.08±5.87) U/L and (25.97 ± 17.48)U/L,respectively,which were significantly decreased compared with that before treatment (205.95± 95.69 )U/L.The differences were statistically significant (t = 93.128 and 81.321, respectively;both P <0.01).In compound glycyrrhizin group,the ALT level before delivery ([104.15 ± 69.15]U/L)was lower than that before treatment ([209.60 ± 102.24]U/L)and the difference was statistically significant (t = 9.281 ,P =0.032).However,the ALT level was fluctuant 6 weeks after delivery (150.26± 86.43)U/L,which was not significantly different from that before treatment (t =2.821 ,P =0.122).The ALT levels before delivery and 6 month after delivery were significantly different in both two groups (t=-2.559 and -3.158,respectively;both P <0.05 ).There were no statistically significant differences between these two groups in the rate of intrauterine infection, duration of pregnancy,delivery mode,neonate weight and disability rate.Conclusion The using of telbivudine for pregnant women with HBeAg negative CHB can effectively control the hepatitis activation and reduce the virus titer.
