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目的:观察妊娠后期核苷类抗病毒药物阻断乙型肝炎母婴传播效果。方法:对于HBV DNA≥10×5e拷贝/mL的孕中妇女,经知情同意服用药物的作为治疗组,于妊娠28周以后加用替比夫定600 mg,1次/d,用药期间监测CK变化;不能接受抗病毒药物治疗的作为对照组。两组患者新生儿于出生后6 h内采血,检测HBsAg、HBV DNA,比较新生儿的阳性率。结果:治疗组产前HBV DNA水平较初检明显下降(t=8.14,P<0.001),并且明显低于对照组;治疗组新生儿HBsAg、HBV DNA阳性率分别为14%、0,低于对照组(字2=4.19、5.09,P<0.05)。治疗组1例发生CK一过性升高。结论:核苷类抗病毒药物阻断乙型肝炎母婴传播有良好的效果,并且能减少并发症的发生。用药期间要加强CK监测,注意药品不良反应的发生。
Objective: To observe the effects of nucleoside antiviral drugs in the late pregnancy on the block of hepatitis B virus (HBV) transmission. Methods: Pregnant women with HBV DNA≥10 × 5e copies / mL were treated with informed consent to take the drug as the treatment group, and telbivudine 600 mg once daily after 28 weeks gestation. Change; can not accept antiviral therapy as a control group. Neonates in both groups were taken blood within 6 h after birth to detect HBsAg and HBV DNA, and to compare the positive rate of neonates. Results: Prenatal HBV DNA levels in treatment group were significantly lower than those in primary examination (t = 8.14, P <0.001), and were significantly lower than those in control group. The positive rates of HBsAg and HBV DNA in treatment group were 14%, 0, Control group (word 2 = 4.19, 5.09, P <0.05). One case of treatment group had a transient elevation of CK. Conclusion: Nucleoside antiviral drugs have a good effect of blocking mother-to-child transmission of hepatitis B, and can reduce the incidence of complications. During the medication to strengthen CK monitoring, pay attention to the occurrence of adverse drug reactions.