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目的:观察替比夫定联合乙肝疫苗阻断胎儿宫内感染乙肝病毒(HBV)的疗效及安全性。方法:53例诊断为中晚期妊娠(妊娠22~30周)合并乙肝孕妇,根据患者情况,分为治疗组(35例,口服替比夫定抗病毒治疗)和对照组(18例,只应用复方甘草酸苷片治疗)。两组均在分娩后采取脐带血检测HBV血清学标志,24 h内给新生儿各注射乙肝免疫球蛋白200 U及乙肝疫苗10μg,并分别于1、6个月时再次注射乙肝疫苗10μg。结果:在分娩时检测,显示治疗组母亲HBV DNA定量减少,谷氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)恢复正常,1年后复查幼儿血清中HBsAg,治疗组幼儿HBV阳性为0,对照组幼儿HBV阳性者3例。结论:替比夫定联合乙肝疫苗治疗中晚期妊娠合并乙肝孕妇是有效、安全的,可有效阻断乙肝病毒母婴垂直传播。
Objective: To observe the efficacy and safety of telbivudine combined with hepatitis B vaccine in preventing intrauterine infection of hepatitis B virus (HBV). Methods: 53 cases were diagnosed as intermediate-to-late pregnancy (22 to 30 weeks of gestation) pregnant women with hepatitis B. According to the patients, they were divided into treatment group (35 cases, oral telbivudine antiviral treatment) and control group (18 cases) Compound glycyrrhizin tablets treatment). In both groups, cord blood was used to detect HBV serological markers after childbirth, and newborns were injected with 200 U of hepatitis B immunoglobulin and 10 ug of hepatitis B vaccine within 24 hours, and 10 μg of hepatitis B vaccine was injected again at 1,6 months. Results: At the time of delivery, the detection of HBV DNA, the activity of ALT and AST in the treatment group returned to normal, and the level of HBsAg in the toddler’s serum was examined one year later. The treatment group The positive rate of HBV in infants was 0, while in the control group, 3 were HBV positive. Conclusion: Telbivudine combined with hepatitis B vaccine is effective and safe in the treatment of pregnant women with middle-late pregnancy combined with hepatitis B, which can effectively block the vertical transmission of hepatitis B virus.