请问战友，我还在打干扰素期间能要小孩吗

z3f

StephenW 发表于 2011-12-28 21:09
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"干扰素除治疗慢性病毒性肝炎外，因为能抑制细胞增殖，所以还用来作为抗肿瘤的生物治疗药 ...

大叔，如果蔡皓东和骆抗先都是错误的，那么，我们还会相信谁呢？
呵呵…

z3f

一、蔡皓东的观点：
　　干扰素与精子或精液的文献有12篇。这些文献都证明干扰素在人体试验和动物试验中均有抗生殖作用。在其中一篇文献中，医生对长效干扰素+利巴韦林的男性患者进行的精液的检查，发现这些病人的精子数量减少，圆细胞/精子比(反映精子异常)增加，停药4个月后才恢复正常；另外，这些病人的精液DNA碎片指数(反映精液染色体结构)明显增加，且停药8个月后仍未恢复正常( http://www.ncbi.nlm.nih.gov/pubmed/20399525 )。说明干扰素明显影响了男性患者的生育质量，因此建议男性患者在停用干扰素后仍要避孕6-8个月以上。

二、骆抗先的观点：
男性能 随意用药吗 ？

有些人认为胎儿在孕妇腹内发育，孕妇服药才要小心；没有想一想胎儿是从一个受精卵细胞大量增殖发育的。如果药物会使精子发生微细的改变，也同样能使胚胎发育畸形，所以想授孕的男性同样不能随意用药。

干扰素对胚胎有什么影响？

干扰素除治疗慢性病毒性肝炎外，因为能抑制细胞增殖，所以还用来作为抗肿瘤的生物治疗药物。胚胎就是从一团细胞经过无数次的分裂、繁殖，发育成胎儿的，所以怀孕期间不能用干扰素。用这类药物治疗肝炎的青年男女，需要停药 3 个月才能生育。

z3f

以上均出自本帖，有兴趣的话，可以吃看看！
【婚恋育智囊】结婚恋爱生育健康常识普及指南
http://www.hbvhbv.com/forum/thread-1098842-7-1.html

StephenW

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相信科学证据.

乙肝
本人男性，小三阳，治疗前DNA肝功能不正常。妻子正常有抗体
至今我打了一年半普通干扰素500万，打之前就是小三阳，DNA肝功能不正常，打后两个月指标就正常了。现发现妻子怀孕一个月,怀孕期间我干扰素没有停.
尊敬的大夫，现在全家人都很着急，这个孩子能要吗？干扰素对精子的影响是否明确？真的只能打掉孩子吗，可是很舍不得啊？毕竟已经怀上了，希望医生指导！如果没什么大的影响，我想要孩子！您接触过这种情况吗？谢谢！

医生　 发表于 2011-07-06

首 先需要说明的是干扰素并没有人类妊娠方面的研究资料，在动物方面的研究并没有发现导致畸形的作用，可以推测退人类的胎儿也应该没有影响，但是这毕竟只是间接证据，而其说明书中是禁止治疗期间怀孕的，所以没有临床证据。当然在实际中少数人确实在治疗期间怀孕，也没有导致宝宝异常。总之，现在的所有证据都没有发现干扰素对胎儿有不利影响，但是没有足够的证据证明这一点，而由于伦理方面的限制，也不可能有这样的证据，任何负责人的医师也难以给出科学的答案，如果是我，我会选择留下孩子，毕竟没有任何证据显示可能有影响。

StephenW

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看看这份最新报告:
Reprod Toxicol. 2011 Dec 19.Source:
http://www.ncbi.nlm.nih.gov/pubmed/22200624 A systematic review of the
fetal safety of interferon alpha. Yazdani Brojeni P, Matok I, Garcia
Bournissen F, Koren G. The Motherisk Program, Hospital for Sick Children,
University of Toronto, Canada.

Abstract
BACKGROUND:
Interferon alpha (IFN) is an effective treatment for a variety of
conditions including essential thrombocythemia (ET), chronic myelocytic
leukemia, Hepatitis B and C. Because these conditions also occur in women
of childbearing age who may become pregnant, information regarding the
safety of this medication in pregnancy is essential. This systematic review
attempts to summarize all published data on outcome of pregnancies exposed
to IFN alpha, trying to differentiate between disease effect and drug
effect.

METHODS:
Reports on the use of IFN alpha in human pregnancy and reports on essential
thrombocythemia (ET) without use of any medication in pregnancy were
identified by a systematic search of the medical literature. We were able
to locate only case reports of IFN alpha exposure in pregnancy, of whom 40
out of 63 were diagnosed with ET. We also collected randomly 71 cases (more
cases were available in the literature) that were diagnosed with ET due to
different etiologies, but who had not received any medication in
pregnancy.

RESULTS:
Among the 63 IFN alpha exposures in pregnancy, the mean maternal age was
30±6 years and the mean full term babies' weight was 3096±463g. Mean
gestational age at delivery was 37±3 weeks. There were 55 single and 4
twin pregnancies. No cases of major malformations or stillbirths were
reported. There was one case of spontaneous abortion and 13 preterm
deliveries (20% of all exposed cases). Among the 71 cases with untreated ET
in pregnancy of different etiologies, 46 (65%) had early (within the first
12 weeks of pregnancy) or late (13-20 weeks of gestation) pregnancy loss.
There were also 3 cases (4%) of stillbirth and 4 cases (5.6%) of preterm
delivery. Only 18 women (25%) delivered healthy term babies.

CONCLUSIONS:
The results of our systematic review suggest that IFN-? does not
significantly increase the risk of major malformation, miscarriage,
stillbirth or preterm delivery above general population rates. It is also
possible that IFN-? may have a protective effect against pregnancy loss in
cases of ET.

StephenW

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且停药8个月后仍未恢复正常( http://www.ncbi.nlm.nih.gov/pubmed/20399525 )。说明干扰素明显影响了男性患者的生育质量，因此建议男性患者在停用干扰素后仍要避孕6-8个月以上。

这是一个错误的和误导性的的结论:
http://www.ncbi.nlm.nih.gov/pubmed/20399525:
J Hepatol. 2010 Jun;52(6):812-6. Epub  2010 Mar 23.
Seminal fluid ribavirin level and functional semen parameters in patients with chronic hepatitis C on antiviral combination therapy.Hofer H, Donnerer J, Sator K, Staufer K, Scherzer TM, Dejaco C, Sator M, Kessler H, Ferenci P.
SourceDepartment of Internal Medicine III, Division of Gastroenterology and Hepatology, Medical University of Vienna, Waehringerguertel 18-20, Vienna, Austria. [email protected]

AbstractBACKGROUND & AIMS: Due to the possible teratogenic effect of ribavirin, effective contraception is mandatory during antiviral therapy in patients with chronic hepatitis C (CHC). The aim of this study was to evaluate seminal parameters and ribavirin and HCV-RNA concentrations in seminal fluid and serum prior to and during antiviral treatment.
PATIENTS AND METHODS: Fifteen male patients (age: 42+/-9 (years+/-SD)) with CHC treated with pegylated interferon-alpha-2a and ribavirin were investigated. Seminal fluid (sperm concentration, motility, and morphology) was analysed morphologically. HCV-RNA and ribavirin concentration were determined by quantitative PCR and HPLC, respectively. Examinations were carried out at baseline, week 4, and week 12.
RESULTS: Ribavirin concentration was higher in seminal fluid than in serum (week 4: 5.2+/-2.5 vs. 2.1+/-0.3; week 12: 4.4+/-1.8 vs. 2.0+/-0.3 (microg/ml, mean+/-SD; p<0.001)). Semen abnormalities were common at baseline (asthenoteratozoospermia: n=6; asthenozoospermia: n=3; teratozoospermia: n=3). Sperm density (BL: 67+/-33x10(6)/ml; week 4: 42+/-25 (p<0.05); week 12: 49+/-33 (n.s.)), percentage of sperm with progressive motility (BL: 40+/-26%; week 4: 27+/-25; week 12: 31+/-20 (n.s.)), and percentage of sperm with normal morphology (BL: 25+/-15; week 4: 20+/-11; week 12: 16+/-9; p<0.05 for both) further decreased during antiviral therapy. HCV-RNA was detectable in the seminal fluid of only two patients prior to antiviral therapy and was undetectable in all patients during combination therapy.
CONCLUSION:

Semen abnormalities were common in CHC patients, with further impairment during antiviral therapy. Ribavirin concentration was elevated twofold in seminal fluid compared to serum levels, which reinforces the need for contraception during antiviral combination therapy.

精液异常是常见的CHC患者，在抗病毒治疗的进一步减值。利巴韦林浓度升高，精液双重相比，血清水平，加强在抗病毒联合疗法用于避孕的需要。

利巴韦林,不是干扰素!

z3f

StephenW 发表于 2011-12-29 10:58
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且停药8个月后仍未恢复正常( http://www.ncbi.nlm.nih.gov/pubmed/20399525 )。说明干扰 ...

大叔，你很给力哦...


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