人类免疫缺陷病毒感染孕妇抗病毒治疗母婴阻断的效果研究  

Effect of PMTCT antiretroviral therapy on pregnant women infected with human immunodeficiency virus

作　　者：陶承静[1] 胡健女[1] 郑经香[2] 陈蓉[1] 张素英[1] 

机构地区：[1]浙江中医药大学附属第六医院杭州市西溪医院妇产科,浙江杭州310023 [2]浙江中医药大学附属第六医院杭州市西溪医院门诊办公室,浙江杭州310023

出　　处：《中华医院感染学杂志》2016年第10期2351-2353,共3页Chinese Journal of Nosocomiology

基　　金：浙江省卫计委医药卫生计划基金资助项目(2013KYB059)

摘　　要：目的探讨人类免疫缺陷病毒（HIV）感染孕妇经母婴阻断治疗的临床效果,为临床HIV感染孕妇的治疗提供参考依据。方法选取2013年4月-2015年4月医院被确诊为HIV感染的38例孕妇,均给予抗病毒治疗、安全分娩方式、新生儿人工喂养;根据HIV感染孕妇的妊娠用药时间分为3组,孕前服药的16例为A组,14~28周开始服药的13例为B组,28周以后直至临产发现才服药的9例为C组,比较3组HIV感染孕妇的分娩方式,分娩结局以及新生儿HIV的感染情况,采用SPSS16.0软件对数据进行统计分析。结果 3组HIV感染孕妇的分娩方式、分娩结局以及新生儿HIV的感染率比较,差异有统计学意义（P〈0.05）;A、B组的HIV感染孕妇除1例胎膜早破性自然分娩,其余均足月后择期剖宫产,新生儿均为正常的婴儿,18个月后HIV抗体检测为阴性,而C组中,出生的新生儿有1例1年内确认感染并死亡;3组新生儿平均体质量3 138g,A组有5例低体重儿,B组有2例,C组中1例。结论尽早并及时发现HIV感染,并对感染HIV的孕妇采取母婴阻断的抗病毒治疗、产科干预、人工喂养等措施,能有效阻断HIV母婴传播,降低新生儿HIV感染的概率。OBJECTIVE To explore the clinical effect of PMTCT on pregnant women infected with human immunodeficiency virus（HIV）so as to provide guidance for clinical treatment of the pregnant women infected with HIV.METHODS A total of 38 pregnant women who were diagnosed with HIV infection from Apr 2013 to Apr 2015 were enrolled in the study and were given antiretroviral therapy,safe mode of delivery,and artificial feeding.The pregnant women with HIV infection were divided into three groups according to the time of use of drugs：16cases who used drugs before pregnancy were assigned as the group A,13 cases who used drugs at 14-28 weeks of gestational age were assigned as the group B,and 9cases who used drugs after week 28 of gestational age were set as the group C.The modes of delivery,delivery outcomes,and incidence of neonatal infection with HIV were compared among the three groups of pregnant women with HIV infection,and the statistical analysis of data was performed with the use of SPSS16.0software.RESULTS There was significant difference in the mode of delivery,delivery outcome,or incidence of HIV infection in neonates among the three groups of pregnant women with HIV infection（P〈0.05）.All of the pregnant women in the group A and group B received elective cesareans section at full-term of pregnancy except that one case underwent the natural delivery due to premature rapture of fetal membranes,all of the neonates were normal,and the HIV antibody was tested negative after the 18 months.In the group C,however,there was one neonate who died of confirmed infection within one year.The average body weight of the three groups of neonates was 3 138 g,there were 5low birth weight neonates in the group A,2neonates in the group B,1neonate in the group C.CONCLUSIONIt is an effective way to detect the HIV infection as early as possible and conduct the PMTCT antiretroviral therapy,obstetric intervention,and artificial feeding for the pregnant women infected with HIV so as to block the mother to child transmission of HIV and

关 键 词：人类免疫缺陷病毒 感染 母婴阻断 抗病毒治疗 

分 类 号：R512.91[医药卫生—内科学]