广西8市HIV抗体阳性母亲使用预防艾滋病母婴传播药物后对18月龄幼儿身体发育不良的9年回顾性研究  

A 9-year retrospective review on 18-month-old infants with physical dysplasia born by HIV-positive mothers received antiretroviral drugs for PMTCT in 8 cities of Guangxi

作　　者：葛宪民[1] 蓝光华[1] 朱金辉[1] 蒋武[2] 梁旭[3] 邓鑫晖 林兆森[5] 覃熙茂 韦宁 农爱丹 郭伟贵[9] 陈欢欢[1] 李彬[1] 温平镜 李江恒 林倩[10] 覃允 孟琴[1] 罗柳红[1] 邓月琴 李珊珊 刘帅凤[1] 吴秀玲[1] 黄精华[1] GE Xian-min;LAN Guang-hua;ZHU Jin-hui;JIANG Wu;LIANG Xu;DENG Xin-hui;LIN Zhao-sen;QIN Xi-mao;WEI Ning;NONG Ai-dan;GUO Wei-gui;CHEN Huan-huan;LI Bin;WEN Ping-jing;LI Jiang-heng;LIN Qian;QIN Yun;MENG Qin;LUO Liu-hong;DENG Yue-qin;LI Shan-shan;LIU Shuai-feng;WU Xiu-ling;HUANG Jing-hua(Guangxi Zhuang Autonomous Region Center for Disease Control and Prevention,Nanning,Guangxi 530028,China;Nanning Municipal Maternal and Child Health Care Hospital,Nanning,Guangxi 530011,China;Baise Municipal Center for Disease Control and Prevention,Baise,Guangxi 533000,China;Laibin Municipal Center for Disease Control and Prevention,Laibin,Guangxi 546100,China;Qinzhou Municipal Center for Disease Control and Prevention,Qinzhou,Guangxi 535099,China;Yulin Municipal Center for Disease Control and Prevention,Yulin,Guangxi 537000,China;Hechi Municipal Maternal and Child Health Care Hospital,Hechi,Guangxi 530011,China;Chongzuo Municipal Center for Disease Control and Prevention,Chonzuo,Guangxi 532200,China;Beihai Municipal Center for Disease Control and Prevention,Beihai,Guangxi 536000,China;Nanning Municipal Center for Disease Control and Prevention,Nanning,Guangxi 530023,China)

机构地区：[1]广西壮族自治区疾病预防控制中心,南宁530028 [2]南宁市妇幼保健院,南宁530011 [3]百色市疾病预防控制中心,百色533000 [4]来宾市疾病预防控制中心,来宾546100 [5]钦州市疾病预防控制中心,钦州535099 [6]玉林市疾病预防控制中心,玉林537000 [7]河池市妇幼保健院,河池530011 [8]崇左市疾病预防控制中心,崇左532200 [9]北海市疾病预防控制中心,北海536000 [10]南宁市疾病预防控制中心,南宁530023

出　　处：《实用预防医学》2022年第1期37-41,共5页Practical Preventive Medicine

基　　金：广西壮族自治区科技厅广西重点研发计划项目(AB17195010);国家传染病防治科技重大专项“广西防治艾滋病规模化现场流行病学和干预研究”(2018ZX10715008);广西八桂学者艾滋病防控关键技术岗位专项(桂办公厅发[2019]79号)

摘　　要：目的回顾性研究广西8市2010—2018年HIV抗体阳性母亲使用预防艾滋病母婴传播(prevention of mother-to-child transmission of HIV,PMTCT)的抗逆转录病毒药物后对18月龄幼儿身体发育不良的影响,为国家改进PMTCT的用药方案提供依据。方法选取广西8市作为研究现场,按照回顾性病例对照研究设计,病例组为广西8市2010年1月—2018年12月"全国母婴阻断系统数据库"中使用PMTCT药物的HIV抗体阳性母亲及所分娩婴儿,收集分析其使用PMTCT药物的历史卡片和母婴阻断资料及18月龄幼儿体检资料。对照组为相同8市妇幼保健院2018年健康母亲及所分娩婴儿,收集分析其18月龄幼儿体检资料。幼儿身体发育不良定义为身高、体重和头围3项指标中至少1项指标低于正常值范围。结果病例组的HIV抗体阳性母亲及所分娩婴儿使用PMTCT药物率分别为91.38%(2811/3076)和96.41(2954/3064),病例组18月龄幼儿的HIV抗体阳性率为1.21%(37/3064)、死亡率为2.28%(70/3064)、HIV母婴传播率为2.21%。病例组满18月龄健康体检时发现幼儿身体发育不良率为14.57%(301/2066);对照组满18月龄幼儿身体发育不良率为10.39%(563/5419),病例组与对照组差异有统计学意义(P=0.000)。结论广西8市近9年HIV抗体阳性母亲及所分娩婴儿使用PMTCT药物率高,可能导致满18月龄幼儿身体发育不良率较高,应进一步深入研究影响因素。Objective To retrospectively study the adverse influence on physical development of 18-month-old infants born by HIV-positive mothers received antiretroviral drugs for prevention of mother to child transmission of HIV(PMTCT)in 8 cities of Guangxi during 2010-2018,and to provide evidence for our country to better tailor PMTCT medication program.Methods We selected 8 cities in Guangxi as the retrospective research sites.Based on the design of retrospective case-control study,the case group consisted of HIV-positive mothers received PMTCT intervention and their infants selected from the National Maternal and Child Interruption System Database in the 8 cities in Guangxi from January 2010 to December 2018,and the history cards of antiretroviral drugs for PMTCT,the data about interruption of mother-to-infant transmission,and physical examination data regarding the 18-month-old infants were collected and analyzed.The control group was composed of healthy mothers and their infants born in the maternal and child health care hospitals in the 8 cities of Guangxi in 2018,and physical examination data regarding the 18-month-old infants were collected and analyzed.Infant physical dysplasia was defined as at least one of the three indicators of height,weight and head circumference below the normal range.Results The usage rates of antiretroviral drugs for PMTCT in the HIV-positive mothers and their infants in the case group were 91.38%(2,811/3,076)and 96.41(2,954/3,064),respectively.The rates of HIV positive,mortality and mother-to-child transmission among infants aged 18 months in the case group were 1.21%(37/3,064),2.28%(70/3,064)and 2.21%,respectively.Physical examination results indicated that the incidence rates of physical dysplasia in infants aged 18 months in the case group and the control group were 14.57%(301/2,066)and 10.39%(563/5,419),respectively,showing a statistically significant difference between the two groups(P=0.000).Conclusion The usage rate of antiretroviral drugs for PMTCT in the HIV-positive mothers and t

关 键 词：艾滋病病毒 预防艾滋病母婴传播 抗逆转录病毒药物 18月龄幼儿 身体发育 

分 类 号：R714.251[医药卫生—妇产科学]