摘要
目的分析乙型肝炎病毒(HBV)阳性孕妇流行病学特征及母婴阻断情况,为临床宣教和治疗提供更多参考。方法将2015年1月至2019年4月在中山大学附属第三医院建卡并进行母婴阻断治疗的228例慢性HBV孕妇纳入研究。自行设计随访问卷,收集孕妇资料,分析228例HBV阳性孕妇流行病学特征、HBV-DNA载量水平与基因型、乙型肝炎e抗原(HBeAg)和谷丙转氨酶(ALT)的关系、母婴阻断情况。结果228例HBV阳性孕妇,以30岁以上、有肝病家族史、中学、省内、农村、家庭月收入2000~5000元为主,HBeAg和HBV-DNA阳性率分别为69.30%、40.35%,HBV-DNA基因型以B型为主,占53.95%,HBV-DNA载量以高病毒载量为主,占64.04%。HBV-DNA高病毒载量孕妇HBeAg阳性率和ALT异常率大于HBV-DNA低病毒载量(P<0.05)。抗病毒治疗组孕妇母婴阻断成功率显著高于未抗病毒治疗组(P<0.05)。结论就诊的228例HBV阳性孕妇HBeAg和HBV-DNA阳性率较高,HBV-DNA高病毒载量可增加孕妇HBeAg阳性和肝功异常风险,临床应重视高危人群的宣教和治疗,同时对HBV阳性孕妇孕期进行抗病毒治疗可有效阻断母婴传播,提高出生人口素质。
Objective To investigate the epidemiological characteristics and interruption of 228 hepatitis B virus(HBV)positive pregnant women,and to provide more references for clinical education and treatment.Methods A total of 228 chronic HBV pregnant women underwent maternal-neonatal transmission blocking treatment in Third Affiliated Hospital of Sun Yat-sen University from January 2015 to April 2019 were enrolled.Self-designed follow-up questionnaires were used to collect pregnant women′s data.Then the relationship of epidemiological characteristics and HBV-DNA load levels with the genotype,hepatitis B e antigen(HBeAg),and alanine aminotransferase(ALT)was analyzed,moreover,the prevention of mother-to-child transmission was also analyzed.Results A total of 228 HBV-positive pregnant women were mainly over 30 years old,with a family history of liver disease,low education level(<secondary school),provincial residence,rural families,and low family monthly income(2000-5000yuan).The positive rates of HBeAg and HBV-DNA were 69.30%and 40.35%,respectively.The HBV-DNA genotype was mainly B type,accounting for 53.95%,and the HBV-DNA load was mainly high virus load,accounting for 64.04%.The positive rate of HBeAg and abnormal rate of ALT in pregnant women with high HBV-DNA load were higher than those with low HBV-DNA load(P<0.05).The success rate of maternal-neonatal transmission blocking in antiviral treatment group was significantly higher than that in non antiviral treatment group(P<0.05).Conclusion A total of 228 HBV-positive pregnant women are mainly HBeAg positive and HBV-DNA positive cases,and high HBV-DNA viral load can increase the risk of HBeAg positive and liver function abnormalities in pregnant women.Clinical education should be emphasized among high-risk groups,and antiviral treatment during pregnancy for HBV-positive pregnant women can effectively block maternal-neonatal transmission and improve the quality of the newborn population.
作者
麦赞
范建辉
叶敏娟
MAI Zan;FAN Jianhui;YE Minjuan(Department of Obstetrics and Gynecology,Guangzhou Eighth People′s Hospital,Guangzhou,Guangdong 510060,China;Department of Obstetrics and Gynecology,the Third Affiliated Hospital of Sun Yat-sen University,Guangzhou, Guangdong 510630,China)
出处
《公共卫生与预防医学》
2020年第5期131-134,共4页
Journal of Public Health and Preventive Medicine
关键词
乙型肝炎病毒
孕妇
流行病学
母婴阻断
抗病毒治疗
Hepatitis B virus
pregnant women
Epidemiology
Mother-to-child transmission blocking
Antiviral therapy
