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目的:观察慢乙肝高病毒载量孕妇妊娠中晚期抗病毒治疗对母婴阻断效果的影响。方法:选取妊娠中晚期的母婴资料均完备的慢性乙型肝炎孕妇60例,按照服用药物分为替比夫定组、替诺福韦组和对照组,每组20例。比较三组在乙肝母婴阻断的疗效差异。结果:替比夫定组、替诺福韦组与对照组孕妇分娩时、产后12周及产后24周的HBV DNA水平差异均有统计学意义(P<0.05),替比夫定组与替诺福韦组分娩时的HBV DNA水平差异无统计学意义(P>0.05)。三组新生儿出生时HBsAg阳性率、HBsAb阳性率比较差异无统计学意义(P>0.05);替比夫定组、替诺福韦组与对照组新生儿出生后1年HBsAg、HBsAb的水平差异均有统计学意义(P<0.05),替比夫定组与替诺福韦组新生儿出生时、出生后1年HBsAg、HBsAb的水平差异无统计学意义(P>0.05)。结论:替比夫定或替诺福韦在慢乙肝孕妇妊娠中晚期抗病毒治疗,对乙肝母婴阻断的疗效显著,且两种药物无显著差异。
OBJECTIVE: To observe the effect of antiretroviral therapy in pregnant women with chronic hepatitis B virus (HBVDNA) on the blocking effect of maternal and neonatal antiviral therapy. Methods: Sixty pregnant women with complete maternal and neonatal pregnancy were enrolled. Pregnant women with telbivudine, tenofovir, and tenofovir were divided into two groups according to their medication. Comparison of the three groups in hepatitis B maternal and child differences in the efficacy of the block. Results: The levels of HBV DNA in pregnant women at telbivudine, tenofovir and control groups at delivery, 12 weeks postpartum and 24 weeks postpartum were significantly different (P <0.05) No differences were found in the levels of HBV DNA at the delivery of norfovir (P> 0.05). The HBsAg positive rate and HBsAb positive rate of newborns were no significant difference at birth (P> 0.05). The levels of HBsAg and HBsAb at 1 year after birth in telbivudine group, tenofovir group and control group (P <0.05). The levels of HBsAg and HBsAb at 1 year after birth in the telbivudine and tenofovir groups were not statistically different (P> 0.05). CONCLUSION: Telbivudine or tenofovir has an obvious curative effect on the blocking of hepatitis B and M at infants during the third and third trimester of pregnancy, and there is no significant difference between the two drugs.