高效抗逆转录病毒治疗阻断母婴HIV传播及对婴儿生长发育的影响  

Effect of highly .active anti-retroviral therapy on prevention of mother to child transmission of HIV and on infant growth and development

作　　者：何艳[1] 罗艳[1] 丁依玲[2] 郑煜煌[1] 李靖[1] 黄健[2] 李介民[3] 

机构地区：[1]中南大学湘雅二医院感染科,长沙410011 [2]中南大学湘雅二医院产科,长沙410011 [3]中南大学湘雅二医院儿科,长沙410011

出　　处：《中华预防医学杂志》2011年第10期912-915,共4页Chinese Journal of Preventive Medicine

摘　　要：目的研究高效抗逆转录病毒治疗（HAART）阻断母婴HIV传播及对婴儿生长发育的影响。方法2005年5月至2010年6月在某医院感染科和妇产科选择HIV感染的确诊育龄妇女及孕妇16例，观察其分娩的17名新生儿为实验组。孕前或妊娠14—28周开展HAART抗病毒治疗。治疗方案：齐多丈定（AZT）0．3g/次（每日2次）＋拉米丈定（3TC）0．3g／次（每日1次）＋奈韦拉平（NVP）0．2g／次（每只2次）或依非韦伦（EFV）0．6∥次，每日1次，并进行分娩干预和新生儿人工喂养。选取同期分娩的正常婴儿16名为对照组。观察婴幼儿生长发育指标至18个月，同时检测新生儿期和12个月龄时的血红蛋白（Hb）、肝肾功能及血清铁和钙。结果孕妇一般状况良好，对药物有较好的耐受性。实验组新生儿体重、身长、Apgar评分分别为（3．5±0．9）kg、（54．2±3．8）cm、7～10分，对照组分别为（3．6±0．8）kg、（55．6±3．6）cm、8～10分（t体自=1．01，t身＆=6．98，P值均〉0．05）；12个月龄时实验组体重、身高分别为（9．4±1．8）k、（76．3±2．7）CIn，对照组分别为（9．9±2．5）kg、（76．8±2．9）cm（t体重=0．83，t身长=1．00，P值均〉0．05）。新生儿期实验组Hb含量为（126．2±16．7）g/L，对照组为（148．6±20．5）g/L（t=-5．89，P=0．11）。12个月龄时，实验组Hb含量为（125．9±19．8）g/L，对照组为（130．1±18．7）g/L；实验组总胆红素（TB）为（11．7±3．5）μmol／L，对照组为（13．2±3．7）μmoL／L（tHh=-3．82，tTB=-2．14，P值均〉0．05）。新生儿期和12个月龄时实验组血清铁和钙分别为（25．4±5．7）、（26．4±7．2）μmol／L和（2．3±0．6）、（2．8±0．6）moL／L，对照组分别为（26．2±4．9）、（28．1±6．9）μmoL／L和（2．6±0．5）、（3．1±0．5）moL／L（新生儿期：t铁=0．80，t％=-3．00，P值均〉0．0Objective To identify the effect of highly active anti-retroviral therapy （HAART） on prevention of mother to child transmission （ PMTCT ） of HIV and on infant growth and development. Methods A total of 16 HIV-infected women or pregnant women selected in this study received HAART before or 18 -24 weeks after pregnancy. The treatment included taking Zidovudine（AZT） 0. 3 g each time, twice a day, Lamivudine （3TC） 0. 3 g each time, once a day and Nevirapine（NVP） 0. 2 g each time, twice a day or Efavirenz （EFV） 0. 6 g each time, once a day, as well as labor intervention and artificial feeding. The growth index for 17 infants from HIV-infected mothers（experimental group） and 16 normal infants （control group） were observed for 18 months. Neonatal emoglobin （ Hb）, liver and kidney function, serum iron and calcium were detected at neonatal period and at 12th month, respectively. Results All the pregnant women were in good conditions and had tolerance with HAART. The birth weight, length and Apgar score of thenewborns in the experimental group were （ 3.5 ± 0. 9） kg, （54. 2 ± 3.8 ） cm and 7 - 10 scores respectively, however those in the control group were （3.6 ±0. 8）kg, （55.6 ±3.6）cm and 8 - 10 scoreS（tweight = 1. 01 , tlength =6. 98, P 〉 0.05 ） . Weight and length of infants in experimental group were （ 9.36 ± 1.8 ） kg and （76. 3 ± 2. 7） cm at 12th month, while those in control group were （ 9. 86 ± 2. 5 ） kg and （ 76. 8 ± 2. 9 ） cm （tweight = 0. 83, tlength = 1. 00, P 〉 0. 05 ）. The level of Hb in experimental group was （126. 2 ± 16. 7 ）g/L, and was （148.6± 20. 5）g/L in control group （t = -5.89, P = 0. 11 ）. At 12th month, the levels of Hb and the total bilirubin（TB） were（ 125.9 ± 19. 8）g/L and（ 11.7 ± 3.5）μmol/L in experimental group; and those in the control group were （ 130. 1 ± 18.7 ） g/L and （ 13.2 ± 3.7 ） μmol/L （ tHb =- 3. 82, tTB = - 2. 14, P 〉 0. 05 ）. Serum iron and calcium were �

关 键 词：疾病传播 垂直 HIV 高效抗逆转录病毒治疗 胚胎发育 

分 类 号：R714[医药卫生—妇产科学]