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探讨慢性乙型肝炎孕妇中晚期注射乙肝免疫球蛋白及口服替比夫定,对降低乙肝病毒母婴传播的作用及安全性。采集慢性乙型肝炎孕妇200例,随机分成治疗组和对照组,各100例。两组在孕24、28、32、36w均注射乙肝免疫球蛋白200IU,治疗组同时口服替比夫定600mg/d至分娩后,对照组孕妇不作其他处理。所有新生儿出生后2h内注射乙肝免疫球蛋白100IU,同时接种首剂重组乙肝疫苗10μg,免疫程序为0、1、6月三针法。主要观察指标为孕妇HBV-DNA含量及新生儿12个月后的HBs Ag阳性率。治疗组孕妇HBV-DNA含量明显下降,低于对照组,差异有统计学意义(P<0.05);治疗组新生儿12个月后Hbs Ag阳性率为3%,低于对照组12%,差异有统计学意义(P<0.05);两组随访过程中没有发现孕妇及新生儿存在明显的不良反应。HBs Ag阳性的慢性乙肝孕妇,中晚期注射乙肝免疫球蛋白同时口服替比夫定能够降低HBV母婴传播的风险。
To investigate the role of chronic hepatitis B in pregnant women in the late injection of hepatitis B immunoglobulin and oral telbivudine, to reduce the role of hepatitis B virus transmission and safety. 200 pregnant women with chronic hepatitis B were collected and randomly divided into treatment group and control group with 100 cases each. Two groups of pregnant 24,28,32,36 w were injected with hepatitis B immunoglobulin 200IU, the treatment group while oral telbivudine 600mg / d to delivery, the control group pregnant women without other treatment. All newborns within 2h after injection of hepatitis B immune globulin 100IU, at the same time the first dose of recombinant hepatitis B vaccine inoculation 10μg, immunization program for 0, 1, June three needles method. MAIN OUTCOME MEASURES: HBV-DNA content in pregnant women and the positive rate of HBsAg after 12 months of newborns. The HBV-DNA content of pregnant women in the treatment group was significantly lower than that in the control group (P <0.05). The positive rate of Hbs Ag in the treatment group after 12 months was 3%, which was 12% lower than that in the control group (P <0.05). No significant adverse reactions were found in pregnant women and newborns during follow-up between the two groups. HBsAg-positive chronic hepatitis B pregnant women, in the late injection of hepatitis B immunoglobulin while oral telbivudine can reduce the risk of mother-to-child transmission of HBV.