76例经艾滋病母婴阻断治疗的HIV阳性孕妇产后的临床体征和免疫功能变化  

Clinical signs and dynamic changes of immunologic function among 76 cases of post-partum women receiving PMTCT

作　　者：刘帅凤[1] 邓小娥[1] 于丽[1] 唐志荣[1] 刘伟[1] 

机构地区：[1]广西壮族自治区疾病预防控制中心,南宁530028

出　　处：《中国艾滋病性病》2015年第5期385-387,391,共4页Chinese Journal of Aids & STD

摘　　要：目的分析经艾滋病母婴阻断治疗(PMTCT)艾滋病病毒(HIV)阳性孕产妇,产后的临床体征、血色素、肝功能及免疫功能变化情况,为进一步指导艾滋病母婴阻断工作提供科学治疗依据。方法对广西2004-2010年76例经PMTCT的HIV阳性孕产妇,在产后2年定期随访,其中31例产后继续接受高效抗反转录病毒治疗(HAART),45例产后停止HAART,对比分析她们的临床体征及实验室检测的血色素(HGB)、中性粒细胞(NC)、肝功能(ALT)和免疫功能[CD+4T淋巴细胞(简称CD4细胞)]的变化。结果在31例产后服药的孕产妇中,4例在产后平均2年后出现司坦夫定(D4T)药物关联的体型改变,2例自产后1年内出现严重的齐多夫定(AZT)贫血;45例产后停药者未出现相关临床体征。31例产后服药的孕产妇,在产后2年内CD4细胞计数比PMTCT前有显著性提高。45例产后停药的孕产妇,其CD4细胞计数在产后1年以后有显著性下降。31例产后服药和45例产后停止服药的孕产妇,产后2年定期随访HGB,NC,ALT均无显著性变化。结论广西孕产妇在服用AZT药后,对部分孕产妇血色素影响明显,部分孕产妇服用D4T治疗2年后有脂肪转移严重不良反应。艾滋病母婴阻断后停药的孕产妇CD4细胞水平下降较快。在艾滋病母婴阻断后停药或继续服药的孕产妇,其产后2年内的HGB、NC、ALT影响不明显。Objective To evaluate the dynamic changes of the clinical signs,hemoglobin,liver function and immune function for postpartum women who received prevention of mother-to-child transmission（PMTCT）during pregnancy,in order to provide scientific basis for blocking HIV mother-to-child HIV transmission.Method A total of 76HIV-infected women,who received highly active antiretroviral therapy（HAART）for prevention of mother to child transmission（PMTCT）during pregnancy,were followed for 2years after delivery,31 women continued HAART after delivery,while the remaining 45 stopped treatment.Changes in HGB,NC,ALT levels and CD＋4T lymphocyte cell counts between the two groups were compared.Results 1.Among the 31 postpartum women that continued medication after delivery,4（44.4%）developed D4T-associated body shape changes after an average of 2years,and 2（9.0%）developed AZT-associated severe anemia.Drug-induced clinical symptoms were not found among 45 patients that stopped treatment after delivery.2.Among the 31 postpartum women that continued treatment,CD＋4T cells counts increased dramatically compared with before PMTCT.However,45 women who stopped medication showed the opposite situation.3.Changes in HGB,NC,and ALT levels in both groups were not significant during the 2-year follow-up.Conclusion The HGB level of some HIV-infected pregnant women changed dramatically after taking AZT,and some patients developed fat redistribution after taking D4 T.These symptoms need to be carefully considered in future PMTCT and HAART.CD＋4T cells counts of HIV-infected women who received HAART for PMTCT during pregnancy and stopped after delivery,dropped quickly after stopping medication.Changes in HGB,NC,and ALT levels were not significant within 2years after delivery among women with or without HAART after PMTCT.

关 键 词：艾滋病病毒孕产妇 艾滋病母婴阻断 高效抗反转录病毒治疗 CD+4T淋巴细胞 血色素 丙氨酸转氨酶 中性粒细胞 

分 类 号：R512.91[医药卫生—内科学]