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目的:探究替诺福韦酯阻断乙型肝炎病毒母婴垂直传播的临床效果。方法:选取2016年1月至2016年12月在清远市人民医院产检及分娩的携带乙型肝炎病毒的中晚期孕妇60例,分为治疗组和对照组,每组30例,治疗组患者在28孕周开始,每天给予口服替诺福韦酯直至分娩,对照组患者不服用抗病毒药物;分别在孕28周和分娩前对两组患者进行乙型肝炎病毒(HBV)脱氧核糖核酸(DNA)载量,乙型肝炎核心抗体(HBc Ab)、乙型肝炎E抗原(HBe Ag)定量的测定并进行对比;所有婴儿在出生后12 h内注射乙型肝炎免疫球蛋白(HBIG)和重组酵母乙型肝炎疫苗,取婴儿脐带血测定其血清是否存在乙型肝炎表面抗原(HBs Ag),比较两者婴儿HBs Ag阳性率。结果:治疗组患者分娩前HBV DNA载量、HBe Ag定量与孕28周相比均明显降低,差异具有统计学意义(P<0.05);治疗组婴儿出生后脐带血中血清HBs Ag阳性率3.33%,而对照组婴儿出生后脐带血中血清HBs Ag阳性率13.33%,治疗组婴儿阳性率明显更低,差异具有统计学意义(P<0.05)。结论:使用替诺福韦酯阻断乙型肝炎病毒母婴垂直传播的临床效果显著。
Objective: To investigate the clinical effect of tenofovir disoproxil blocking the vertical transmission of hepatitis B virus in mother and infant. Methods: From January 2016 to December 2016 in Qingyuan City People’s Hospital for inspection and delivery of hepatitis B virus in pregnant women with 60 cases, divided into treatment group and control group, 30 cases in each group, the treatment group patients in 28 gestational weeks, oral administration of tenofovir dipivoxil daily until delivery, the control group patients did not take antiviral drugs; respectively, at 28 weeks of pregnancy and before delivery of the two groups of patients with hepatitis B virus (HBV) DNA ), HBcAb and HBeAg were measured and compared. All infants were injected with hepatitis B immunoglobulin (HBIG) within 12 hours after birth and recombinant Yeast Hepatitis B vaccine, take the baby cord blood to determine whether the presence of hepatitis B surface antigen (HBsAg), HBsAg positive rate of both infants. Results: The HBV DNA load and HBeAg quantitation before delivery in the treatment group were significantly lower than those in the 28th week, the difference was statistically significant (P <0.05). The positive rate of HBsAg in the cord blood of the treatment group after birth was 3.33 %, While the positive rate of serum HBsAg in cord blood after birth was 13.33% in the control group. The positive rate of infants in the treatment group was significantly lower, with statistical significance (P <0.05). Conclusion: The clinical effect of tenofovir dipivoxil in blocking the vertical transmission of hepatitis B virus in mother and infant was significant.