【摘要】 目的探讨乙型肝炎(以下简称乙肝)病毒(HBV)携带者妊娠中后期使用替诺福韦在不同停药时间对肝炎发作的影响。方法回顾性分析2017年1月至2018年12月在广州市增城区人民医院产科分娩的慢性乙肝妊娠孕妇80例作为研究对象。根据妊娠孕妇停用替诺福韦时间,将分娩后立即停药和分娩后继续使用替诺福韦12周的产妇分别作为治疗1组和治疗2组,每组30例。另取该院20例拒绝接受替诺福韦抗病毒治疗的产妇作为对照组。比较3组产妇分娩或停药后谷丙转氨酶(ALT)、谷草转氨酶(AST)、总胆红素(TBIL)、HBV-DNA拷贝数及产妇分娩或停药后12周内肝炎发作情况。结果 3组产妇分娩或停药12周后肝功能ALT、AST及TBIL比较,差异无统计学意义(P>0.05)。治疗1组有8例(26.67%)HBV-DNA拷贝数>104IU/mL,治疗2组0例(0.00%) HBV-DNA拷贝数>104IU/mL,对照组有20例(100.00%) HBV-DNA拷贝数>106IU/mL,3组比较,差异有统计学意义(P<0.05)。随访12周内,治疗1组有6例(20.00%)肝炎发作,治疗2组0例(0.00%)肝炎发作,对照组有2例(10.00%)肝炎发作,3组比较,差异有统计学意义(P<0.05)。结论慢性HBV携带孕妇在妊娠中晚期采用替诺福韦治疗,在分娩后立即停药会增加停药后肝炎发作的风险。更多还原

【Abstract】 【Objective】 To investigate different withdrawal time on the onset of hepatitis in mothers with HBV infection who took Tenofovir in the middle and later stages of pregnancy. 【Methods】 A retrospective analysis of 80 pregnant women with chronic HBV who gave birth in the obstetrics department of our hospital from January 2017 to December 2018 was performed.According to different withdrawal time, 30 pregnant women who stop taking Tenofovir immediately after delivery were enrolled into the treatment group 1, another 30 patients who didn’t stop taking Tenofovir until 12 weeks after delivery were included into the treatment group2, and the other 20 patients who never took drugs were assigned into the control group. ALT, AST, TBil, HBV-DNA copy numbers and the ratio of the onset of hepatitis were compared among three groups 12 weeks after delivery. 【Results】Twelve weeks after delivery, there was no significant difference in ALT, AST and TBil among three groups(P>0.05). Eight patients(26.67%) in the treatment group 1 had >104 IU/mL HBV-DNA, none of the patient in the treatment group 2 showed >104 IU/mL HBV-DNA and 20 cases(100.00%) had >106 IU/mL HBV-DNA in the control group. There was significant difference in the ratio of cases with >104 IU/mL HBV-DNA among three groups(P<0.05). During the follow-up period, 6 patients(20.00%) of the treatment group 1 had hepatitis, 0 patients(0.00%) of the treatment group 2 and 2 cases(10.00%) in the control group had hepatitis. There was significant difference in the ratio of the onset of hepatitis among three groups(P<0.05).【Conclusion】The risk of the onset of hepatitis of pregnant women with HBV infection who are treated with Tenofovir in the second and third trimester of pregnancy will increased after withdrawal of drug immediately after delivery.更多还原