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目的评价妊娠晚期应用替比夫定治疗后阻断HBV宫内感染及胎盘HBV感染的效果。方法 38例HBeAg阳性、HBV DNA>7.00 log10拷贝/ml孕妇分为2组:替比夫定组18例,自妊娠(28±2)周行替比夫定600 mg/d阻断治疗至产后1个月;对照组20例,未予替比夫定治疗;新生儿均予主被动联合免疫。ELISA法定量检测孕妇和新生儿乙肝两对半,PCR方法定量检测外周血及胎盘组织HBV DNA。结果替比夫定组孕妇于分娩前血清HBV DNA显著下降至(3.87±1.12)log10拷贝/ml,明显低于对照组的(7.42±0.53)log10拷贝/ml(P<0.01)。替比夫定组胎盘组织HBV DNA为(4.35±0.56)log10拷贝/ml,也明显低于对照组的(5.16±0.40)log10拷贝/ml(P<0.01)。结论妊娠晚期替比夫定抗病毒治疗可有效降低母亲外周血HBV DNA,阻断宫内传播。
Objective To evaluate the effect of blocking telbivudine intrauterine infection and placental HBV infection after telbivudine treatment in the third trimester of pregnancy. Methods 38 cases of HBeAg positive, HBV DNA> 7.00 log10 copies / ml pregnant women were divided into two groups: telbivudine group of 18 patients, since the pregnancy (28 ± 2) weeks of telbivudine 600 mg / d block treatment until after delivery 1 month; control group of 20 patients, not treated with telbivudine; newborn were given primary and passive combined immunization. ELISA quantitative detection of pregnant women and neonatal hepatitis B two and a half, PCR method for quantitative detection of peripheral blood and placental tissue HBV DNA. Results The telbivudine group had significantly lower serum HBV DNA before delivery (3.87 ± 1.12) log10 copies / ml, which was significantly lower than that of the control group (7.42 ± 0.53) log10 copies / ml (P <0.01). HBV DNA in telbivudine-treated placenta was (4.35 ± 0.56) log10 copies / ml and also significantly lower than (5.16 ± 0.40) log10 copies / ml in control group (P <0.01). Conclusion Telbivudine antiviral therapy in late trimester can effectively reduce HBV DNA in mothers’ peripheral blood and block the intrauterine transmission.