论文部分内容阅读
目的:调查拉米夫定治疗期间妊娠的乙型肝炎病毒感染妇女母婴HBV传播及婴儿发育状况。方法:收集我院2002年1月至2007年6月15例应用拉米夫定治疗期间妊娠的乙型肝炎病毒感染妇女的资料。调查分析母婴的肝功能和HBVDNA水平,妊娠并发症以及婴儿发育状况。结果:15例HBV感染妇女年龄为27~32岁(中位数29岁),其ALT和HBV DNA分别为86~405 U/L和6.03×105~2.67×107拷贝/ml。患者接受拉米夫定100 mg,1次/d,用药时间为4~13个月,患者在肝功能恢复正常,HBV DNA<1×105拷贝/ml后开始妊娠,拉米夫定治疗继续至分娩。15例患者的ALT水平在妊娠前和妊娠期均保持正常水平。患者的HBV DNA水平在妊娠前下降至<1×105拷贝/ml(其中80%患者<500拷贝/ml)。在妊娠期间14例未测及HBVDNA;1例的HBVDNA降至2.45×103拷贝/ml,患者ALT水平均降至11~41 U/L(中位数23 U/L)。未见妊娠并发症。6个月婴儿的ALT为8~33 U/L(中位数20 U/L),HBV DNA、HBsAg、HBeAg均为阴性,未见发育异常,新生儿Apgar评分为8~10分。结论:拉米夫定似能有效阻断母婴HBV传播,未见婴儿发育异常。
Objective: To investigate the HBV transmission and infant development in women and children with hepatitis B virus infection during pregnancy during lamivudine treatment. Methods: The data of 15 pregnant women infected with hepatitis B virus during the lamivudine treatment from January 2002 to June 2007 in our hospital were collected. Survey analysis of maternal and neonatal liver function and HBVDNA levels, pregnancy complications and infant development. RESULTS: Fifteen women with HBV infection were 27 to 32 years old (median 29 years) with ALT and HBV DNA levels of 86 to 405 U / L and 6.03 × 105 to 2.67 × 10 7 copies / mL, respectively. Patients received lamivudine 100 mg once daily for 4 to 13 months. Patients returned to normal liver function with a pregnancy after HBV DNA <1 x 105 copies / ml and lamivudine treatment continued until childbirth. ALT levels in 15 patients remained normal before and during pregnancy. Patients’ HBV DNA levels decreased to <1 × 10 5 copies / ml before pregnancy (of which <80 copies were <500 copies / ml). HBVDNA was not detected in 14 cases during pregnancy; HBVDNA was reduced to 2.45 × 103 copies / ml in 1 case, and the ALT level was reduced to 11-41 U / L (median 23 U / L). No complications of pregnancy. The 6-month-old infants had an ALT of 8 to 33 U / L (median 20 U / L). HBV DNA, HBsAg, and HBeAg were all negative and no developmental abnormalities were observed. Apgar scores were 8 to 10 in neonates. Conclusion: Lamivudine can effectively block the transmission of HBV in infants and mothers without any abnormal infant development.