摘要
目的探讨妊娠早期服用拉米夫定(LAM)、替比夫定(LdT)或替诺福韦(TDF)的安全性。方法研究对象选自2007年1月1日至2011年12月31日就诊于北京地坛医院、正在服用LAM、LdT或TDF的慢性乙型肝炎早期妊娠患者,分别为LAM组、LdT组和TDF组。监测3组患者的胎停育、自然流产或异位妊娠情况,计算各组的妊娠失败率,对妊娠失败的原因进行分析,并与以往文献报道的非HBV感染母亲与HBV感染母亲妊娠早期的妊娠失败率比较。结果 LAM组92例95孕次,妊娠失败11孕次(11.6%);LdT组59例62孕次,妊娠失败6孕次(9.7%);TDF组11例12孕次,妊娠失败1孕次(8.3%)。3组妊娠失败率比较差异无统计学意义(P=0.923),并且没有高于以往文献报道的非HBV感染母亲与HBV感染母亲的早期妊娠失败率(11%～16%和16.7%～21.9%)。所有妊娠失败患者均同时患有其他与慢性乙型肝炎无关的疾病。结论慢性乙型肝炎妇女妊娠早期应用LAM、LdT和TDF是比较安全的,不会增加妊娠失败率。
Objective To explore the safety of lamivudine （LAM）, telbivudine （LdT）, and tenofovir （TDF） used in patients in early pregnancy. Methods The chronic hepatitis B patients taking LAM, LdT, and TDF in early pregnancy in Beijing Ditan Hospital from January 1, 2007 to December 31, 2011 were selected as subjects. All subjects were divided into the LAM group, the LdT group, and the TDF group. The situation that embryo stopped growing, spontaneous abortion,and ectopic pregnancy was monitored. The rate of pregnancy failure was calculated and its reason was analyzed. The rates of pregnancy failure were compared with those reported in past papers in the non-HBV affected mothers and HBV affected mothers in early pregnancy. Results Of the 92 patients in the LAM group, 11 （ 11.6% ） failed in the 95 pregnancies. Of the 60 patients in the LdT group, 6（9.5% ） failed in the 62 pregnancies. Of the 11 patients in the TDF group, 1 （9.7%） failed in the 12 pregnancies. There is no statistically significant difference in the rate of pregnancy failure among the 3 groups （P = 0. 923 ）. The rates of pregnancy failure were not higher than those reported in past papers in the non-HBV affected （ 11% - 16% ） and HBV affected mothers （ 16.7% - 21.9% ）. All pregnancy failure patients were suffered from diseases that were not related to chronic hepatitis B. Conclusion Exposure to LAM, LdT, and TDF in early pregnancy is relatively safe to patients with chronic hepatitis B and no increase in the rate of pregnancy failure.
出处
《药物不良反应杂志》
2012年第2期73-76,共4页
Adverse Drug Reactions Journal
关键词
肝炎
乙型
慢性
妊娠初期
拉米夫定
替比夫定
替诺福韦
hepatitis B, chronic
pregnancy trimester, first
lamivudine
telbivudine
tenofovir
