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纸质出版:2013
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吴全新,邓国宏,李俊男,李利,孙小雯,潘美明,黄鸿菲,何登明,晏泽辉,徐城,李茂仕,唐薇,刘明栋,王宇明.HBeAg阳性感染孕妇妊娠期中晚期接受替比夫定治疗对HBsAg、HBeAg及抗-HBc胎盘透过率的影响[J].陆军军医大学学报(原第三军医大学学报),2013,35(07):665-668.
Wu Quanxin,Deng Guohong,Li Junnan,Li Li,Sun Xiaowen,Pan Meiming,Huang Hongfei,He Dengming,Yan Zehui,Xu Cheng,Li Maoshi,Tang Wei,Liu Mingdong,Wang Yuming.Effects of telbivudine on transmission of HBsAg and HBeAg through placenta in HBV infected pregnant women in second or third trimester[J].J Amry Med Univ (J Third Mil Med Univ),2013,35(07):665-668.
吴全新,邓国宏,李俊男,李利,孙小雯,潘美明,黄鸿菲,何登明,晏泽辉,徐城,李茂仕,唐薇,刘明栋,王宇明.HBeAg阳性感染孕妇妊娠期中晚期接受替比夫定治疗对HBsAg、HBeAg及抗-HBc胎盘透过率的影响[J].陆军军医大学学报(原第三军医大学学报),2013,35(07):665-668. DOI:
Wu Quanxin,Deng Guohong,Li Junnan,Li Li,Sun Xiaowen,Pan Meiming,Huang Hongfei,He Dengming,Yan Zehui,Xu Cheng,Li Maoshi,Tang Wei,Liu Mingdong,Wang Yuming.Effects of telbivudine on transmission of HBsAg and HBeAg through placenta in HBV infected pregnant women in second or third trimester[J].J Amry Med Univ (J Third Mil Med Univ),2013,35(07):665-668. DOI:
目的 观察HBeAg阳性、HBV DNA高复制慢性HBV感染孕妇的HBsAg、HBeAg和抗-HBc胎盘透过率,进一步明确替比夫定阻断母婴传播的机制。 方法 回顾性分析在本院例行孕期检查以及产科分娩的HBeAg阳性、HBV DNA≥10
6
IU/mL的慢性HBV感染孕妇84例,根据阻断HBV母婴传播方式不同分为常规双重免疫阻断组(常规组,15例)和双重免疫+替比夫定阻断组(替比夫定组,69例)。检测妊娠中晚期、分娩时母亲和新生儿脐带血清HBsAg、HBeAg及抗-HBc水平。 结果 两组之间母亲及新生儿HBsAg、HbeAg和抗-HBc水平无统计学差异 (孕妇分娩时:HBsAg P=0.058,HBeAg P=0.065,抗-HBc P=0.727;新生儿脐血:HBsAg P=0.761,HBeAg P=0.225,抗-HBc P=0.924),且两组之间的HBsAg和HBeAg胎盘透过率亦无统计学差异(分别为P=0.172,0.163)。两组新生儿脐带血抗-HBc透过率均为阳性。 结论 妊娠中晚期替比夫定不能降低孕妇HBsAg、HBeAg水平和HBsAg、HBeAg的胎盘透过率,其阻断HBV母婴传播的机制可能主要与有效降低孕妇HBV DNA水平有关。透过率与母亲HBsAg和HBeAg水平不成平行关系。
Objective To determine the change of transmission of HBsAg
HBeAg and anti-HBC through placenta in HBV infected pregnant women at the second and third trimesters after the treatment of telbivudinein. Methods We systematically investigated 69 mothers with HBeAg positive and HBV DNA levels ≥10
6
IU/mL who made routine pregnancy checks in our hospital from Feburary 2008 to October 2012 and receive
d telbivudine at 600 mg per day from 24th to 33th week of gestation. Another 15 pregnant women at the same situation who were unwilling to receive the treatment served as control. All the mothers and the cordblood of infants were detected for the serum HBV markers (HBsAg
anti-HBs
HBeAg
anti-HBe
HBV DNA). Results There was no significant difference in serum levels of HBsAg
HBeAg and anti-HBC titers in the mothers and their infants from either the telbivudine group or the untreated group (serum of mothers at delivery
HBsAg P=0.058
HBeAg P=0.065; blood of infants
HBsAg P=0.761
HBeAg P=0.225). There was alson no difference of the transmission rate of HBsAg and HBeAg between two groups (P=0.172 and P=0.163). The sesum anti-HBc could absolutely transit the placenta in the two groups. Conclusions We demonstrated that telbivudine couldn’t effectivly downregrade the levels of serum HBsAg and HBeAg of the mothers and the transmission rate of cordblood in the telbivudine group. The mechanism of telbivudine preventing mother to infant transmission might be due to its declining the levels of HBV DNA. The levels of serum HBsAg and HBeAg in the mother is not parallel to the transmission rate of cordblood and the mothers.
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