摘要
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HBV DNA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—405U／L和6．03×10^5～2．67×10^7拷贝／ml。患者接受拉米夫定100mg，1次／d，用药时间为4—13个月，患者在肝功能恢复正常，HBVDNA〈1×10^5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〈1×10^5拷贝／ml（其中80％患者〈500拷贝／ml）。在妊娠期间14例未测及HBV DNA；1例的HBV DNA降至2．45×10^3拷贝／ml，患者ALT水平均降至11—41U／L（中位数23U／L）。未见妊娠并发症。6个月婴儿的ALT为8—33U／L（中位数20U／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 mother-to-infant HBV transmission and infant development in pregnant women with HBV infections during lamivudine therapy. Methods： The data of 15 pregnant women during lamivudine therapy from January 2002 to June 2007 were collected. The liver function and HBV DNA levels of mothers and infants, complications of pregnancy, and infant development were investigated and analyzed. Results ： Fifteen women with HBV infections were 27 - 32 years old （ median age 29 years）. Their ALT and HBV DNA levels were 86 - 405 U/L and 6.03 × 10^5 - 2.67 × 10^7 copies/ml, respectively. They received lamivudine 100 mg once daily. The treatment time was 4 - 13 months. The women started to become pregnant after their liver functions returned to normal and HBV DNA levels decreased to 〈 1 × 10^5 copies/ml. Lamivudine therapy was continued until labor. Their ALT levels remained normal before and during pregnancy. Their HBV DNA levels decreased to 〈 1 × 10^5 copies/ml （80% of the patients 〈 500 copies/ml） before pregnancy. And during pregnancy, 14 patients＇HBV DNA levels were not detectable, one patient＇s HBV DNA level decreased to 2.45 × 10^3 copies/ml. And their ALT levels decreased to 11 - 41 U/L（median level 23 U/L）. No complications of pregnancy were found. The six-month infants ＇ALT levels were 8 - 33 U/L （ median level 20 U/L）, their HBV DNA, HBsAg, and HBeAg were negative, and no abnormal development was observed. Apgar score to neonate was 8 - 10. Condusion： Lamivudine appears to be effective in preventing mother-to-infant HBV transmission, and the investigation found no abnormal infant development .
出处
《药物不良反应杂志》
2008年第4期249-251,共3页
Adverse Drug Reactions Journal
关键词
乙型肝炎病毒感染
妊娠
母婴传播
拉米夫定
婴儿发育
hepatitis B virus infection
pregnancy
mother-to-infant transmission： lamivudine
infant development
