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[摘要]
目的 探討替比夫定聯(lián)合促肝細(xì)胞生長素治療妊娠早期慢性乙型肝炎的臨床。方法 選取2013年1月-2015年6月在邯鄲市傳染病醫(yī)院接受治療的妊娠早期慢性乙型肝炎患者83例,隨機(jī)分為對照組(42例)和治療組(41例)。對照組靜脈滴注促肝細(xì)胞生長素注射液,120 μg加入到10%葡萄糖溶液200 mL中,1次/d。治療組在對照組基礎(chǔ)上睡前口服替比夫定片,600 mg/次,1次/d。兩組患者均治療8周。觀察兩組的臨床療效,比較兩組乙型肝炎病毒脫氧核糖核酸(HBV-DNA)、丙氨酸轉(zhuǎn)氨酶(ALT)、天氨酸轉(zhuǎn)氨酶(AST)和嬰兒乙肝表面抗體(抗-HBs)的水平。結(jié)果 治療4、8周后,對照組輕度患者有效率分別為52.63%、68.42%;治療組輕度患者有效率分別為85.00%、100.00%,兩組有效率比較差異有統(tǒng)計學(xué)意義(P<0.05)。治療4周后,對照組ALT水平明顯下降,而治療組HBV-DNA、ALT和AST水平均明顯下降,同組治療前后比較差異有統(tǒng)計學(xué)意義(P<0.05);且治療組這些觀察指標(biāo)的降低程度明顯優(yōu)于對照組,兩組比較差異具有統(tǒng)計學(xué)意義(P<0.05)。隨訪后,對照組和治療組嬰兒抗-HBs陽性率分別為59.52%、80.49%,兩組比較差異有統(tǒng)計學(xué)意義(P<0.05)。結(jié)論 替比夫定聯(lián)合促肝細(xì)胞生長素治療妊娠早期慢性乙型肝炎具有較好的臨床療效,可阻斷乙型肝炎病毒(HBV)母嬰傳播,安全性較好,具有一定的臨床推廣應(yīng)用價值。
[Key word]
[Abstract]
Objective To investigate the clinical effect of telbivudine combined with hepatocyte growth-promoting factors in treatment of chronic hepatitis B in early pregnancy. Methods Patients (83 cases) with chronic hepatitis B in early pregnancy in Handan Infectious Disease Hospital from January 2013 to June 2015 were randomly divided into the control group (42 cases) and the treatment group (41 cases). Patients in the control group were iv administered with Hepatocyte Growth-Promoting Factors Injection, 120 μg added into 10% glucose solution 200 mL, once daily. Patients in the treatment group were po administered with Telbivudine Tablets on the basis of the control group, 600 mg/time, once daily. Patients in two groups were treated for 8 weeks. After treatment, the clinical efficacies were evaluated, and the levels of HBV-DNA, ALT, AST, and HBsAb in two groups were compared. Results After treatment for 4 and 8 weeks, the clinical efficacies of mild patients in the control group were 52.63% and 68.42%, respectively, but the clinical efficacies of mild patients in the treatment group were 85.00% and 100.00%, respectively, and there was difference between two groups (P<0.05). After treatment for 4 weeks, the level of ALT in the control group was significantly decreased, but the levels of HBV-DNA, ALT, and AST in the treatment groups were significantly decreased, and the difference was statistically significant in the same group (P<0.05). And the observational indexes in the treatment group were significantly better than those in the control group, with significant difference between two groups (P<0.05). After follow-up, the positive rate of infant HBsAb in the control and treatment groups were 59.52% and 80.49%, respectively, and there was difference between two groups (P<0.05). Conclusion Telbivudine combined with hepatocyte growth-promoting factors has clinical curative effect in treatment of chronic hepatitis B in early pregnancy, and can block the mother to child transmission of HBV, with good safety, which has a certain clinical application value.
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