CAJ | 학술논문

目的：探讨替比夫定治疗妊娠期 e 抗原阴性慢性乙型肝炎的临床效果。方法选择90例 e 抗原阴性慢性乙型肝炎孕妇，并通过数字表法将患者随机分为两组，分为观察组50例，对照组40例。观察组孕妇使用替比夫定治疗，对照组孕妇使用复方甘草酸苷治疗。对比两组孕妇治疗前后 HBV DNA 水平、转阴率、血清 ALT 水平、妊娠结局。结果观察组与对照组治疗后 HBV-DNA 水平相比治疗前均显著降低，对照组患者治疗前为（6．37±1．18）mL，分娩后6周为（5．49±1．21）mL；观察组患者治疗前为（6．31±1．21）mL，分娩后6周为（0．23±0．04）mL，差异有统计学意义（t ＝8．154，P ＜0．01）；观察组分娩前、分娩后6周 HBV-DNA 分别为（0．21±0．05）lg Copeis／mL、（0．23±0．04）lg Copeis／mL，均明显低于对照组，经过统计学处理，差异有统计学意义（t ＝19．257，P ＝0．000；t ＝8．154，P ＝0．000）；观察组治疗后4周、治疗后8周、分娩后6周 HBV-DNA转阴率分别为52．00％、60．00％、88．00％，均显著高于对照组，经过统计学处理，差异均有统计学意义（χ2＝142．41、184．58、177．61，P ＜0．01）；观察组与对照组治疗后 ALT 水平相比治疗前均有显著降低，经过统计学处理，差异有统计学意义（t ＝29．665，P ＜0．01）；观察组分娩前、分娩后6周 ALT 分别为（12．58±2．58）U ／L、（18．44±3.43）U ／L，均明显低于对照组，经过统计学处理，差异有统计学意义（t ＝54．251，P ＝0.000；t ＝29.665，P ＝0.000）；观察组不良妊娠发生率为14．00％，与对照组比较差异无统计学意义（χ2＝0.524，P ＝0.493）。结论替比夫定治疗妊娠期 e 抗原阴性慢性乙型肝炎临床效果较好，可控制肝炎活动，降低病毒水平，值得临床推广应用。
목적：탐토체비부정치료임신기 e 항원음성만성을형간염적림상효과。방법선택90례 e 항원음성만성을형간염잉부，병통과수자표법장환자수궤분위량조，분위관찰조50례，대조조40례。관찰조잉부사용체비부정치료，대조조잉부사용복방감초산감치료。대비량조잉부치료전후 HBV DNA 수평、전음솔、혈청 ALT 수평、임신결국。결과관찰조여대조조치료후 HBV-DNA 수평상비치료전균현저강저，대조조환자치료전위（6．37±1．18）mL，분면후6주위（5．49±1．21）mL；관찰조환자치료전위（6．31±1．21）mL，분면후6주위（0．23±0．04）mL，차이유통계학의의（t ＝8．154，P ＜0．01）；관찰조분면전、분면후6주 HBV-DNA 분별위（0．21±0．05）lg Copeis／mL、（0．23±0．04）lg Copeis／mL，균명현저우대조조，경과통계학처리，차이유통계학의의（t ＝19．257，P ＝0．000；t ＝8．154，P ＝0．000）；관찰조치료후4주、치료후8주、분면후6주 HBV-DNA전음솔분별위52．00％、60．00％、88．00％，균현저고우대조조，경과통계학처리，차이균유통계학의의（χ2＝142．41、184．58、177．61，P ＜0．01）；관찰조여대조조치료후 ALT 수평상비치료전균유현저강저，경과통계학처리，차이유통계학의의（t ＝29．665，P ＜0．01）；관찰조분면전、분면후6주 ALT 분별위（12．58±2．58）U ／L、（18．44±3.43）U ／L，균명현저우대조조，경과통계학처리，차이유통계학의의（t ＝54．251，P ＝0.000；t ＝29.665，P ＝0.000）；관찰조불량임신발생솔위14．00％，여대조조비교차이무통계학의의（χ2＝0.524，P ＝0.493）。결론체비부정치료임신기 e 항원음성만성을형간염림상효과교호，가공제간염활동，강저병독수평，치득림상추엄응용。
Objective To investigate clinical effect of telbivudine used in e antigen -negative chronic hepatitis B pregnant patients,to provide a reference for clinical treatment.Methods 90 pregnant patients with chronic hepatitis B e antigen -negative were selected,they were divided into two groups,50 patients in the control group and 40 patients in the observation group.The observation group used telbivudine treatment,the control group used the compound glycyrrhizin treatment.Before and after treatment,HBV DNA levels,negative rate,serum ALT levels,pregnancy outcome were compared between the two groups.Results After treatment,HBV -DNA in the two groups was significantly decreased compared with before treatment,before treatment,the HBV -DNA of the control group was (6.37 ± 1.18)mL,6 weeks after delivery was (5.49 ±1.21)mL;before treatment,the HBV -DNA of the observation group was (6.31 ±1.21)mL,6 weeks after delivery was (0.23 ±0.04)mL.The difference was statistically significant (t =8.154,P <0.01 ).In the observation group,before birth,six weeks after childbirth HBV -DNA were (0.21 ± 0.05)lg copy/mL,(0.23 ±0.04)lg copy/mL,which were significantly lower than those of the control group,the differences were significant (t =19.257,P =0.000;t =8.154,P =0.000).4 weeks,8 weeks after treatment,six weeks after childbirth,the HBV -DNA negative conversion rates of the control group were 52.00%,60.00%, 88.00%,which were significantly lower than the observation group (χ2 =177.61,142.41,184.58,P <0.01 ). Compared with before treatment,ALT levels after treatment were significantly decreased in the two groups (t =29.665,P <0.01).Before birth,six weeks after birth,ALT levels in the observation group were (12.58 ±2.58)U /L, (18.44 ±3.43)U /L,which were significantly lower than the control group (t =54.251,P =0.000;t =29.665,P =0.000).The incidence rate of adverse pregnancy of the observation group was 14.00%,compared with the control group the difference was not statistically significant (χ2 =0.524,P =0.493 ).Conclusion Telbivudine in the treatment of gestational e antigen -negative chronic hepatitis B pregnant patients has good clinical effect,it can help to control hepatitis activity and reduce virus levels,which is worthy of clinical application.