艾滋病母婴阻断治疗对HIV阳性孕妇产后HGB和ALT与CD4+T淋巴细胞的影响  

Effect of mother-to-child blocking therapy on postpartum HGB,ALT and CDT of HIV-positive pregnant women

作　　者：林和先 符爱贞 韩曼琳 孙虹[2] 周爱梅[1] LIN He-xian;FU Ai-zhen;HAN Man-lin;SUN Hong;ZHOU Ai-mei(Haikou Maternal and Child Health Hospital,Haikou,Hainan 570203,China)

机构地区：[1]海口市妇幼保健院产科,海南海口570203 [2]海口市妇幼保健院感染控制科,海南海口570203

出　　处：《中华医院感染学杂志》2020年第13期2043-2047,共5页Chinese Journal of Nosocomiology

基　　金：海南省卫生计生行业科研基金资助项目(16A200137)。

摘　　要：目的探究艾滋病母婴阻断治疗对人类免疫缺陷病毒(HIV)阳性孕妇产后血红蛋白(HGB)、谷丙转氨酶(ALT)、CD4+T淋巴细胞的影响。方法回顾性分析2015年5月-2017年5月海口市妇幼保健院收治的80例HIV阳性孕妇资料,将其中40例HIV阳性孕妇在产后坚持使用高效抗反转录病毒治疗(HAART)列为治疗组,40例HIV阳性孕妇在产后停止使用HAART治疗列为对照组。对两组进行2年的随访,观察并记录两组母婴阻断效果,比较两组产后6、12、18、24个月的HGB、ALT水平及CD4+T淋巴细胞计数。结果两组母婴阻断有效率无统计学差异。治疗组孕36周和产后6、12、18、24个月的HGB、ALT和CD4+T淋巴细胞差异具有统计学意义(P<0.001);对照组孕36周和产后6、12、18、24个月的HGB、ALT和CD4+T淋巴细胞差异具有统计学意义(P<0.001)。与孕36周相比,两组产后6、12、18、24个月的HGB水平均升高(P<0.05),与孕36周比,治疗组在产后6、12、18、24个月ALT均升高(P<0.05),且治疗组产妇在产后6、12个月的ALT水平高于对照组(P<0.05),在产后18、24个月的ALT水平低于对照组(P<0.05),与孕36周相比,治疗组产后6、12、18、24个月的CD4+T淋巴细胞增多(P<0.05),且产后6、12、18、24个月治疗组的CD4+T淋巴细胞多于对照组(P<0.05)。结论HAART治疗可以有效阻断母婴传播,产后继续治疗可以增加HIV阳性孕妇产后免疫功能,但可损伤肝功能,对HGB影响不大。OBJECTIVE To explore the effect of mother-to-child blocking therapy on postpartum hemoglobin(HGB),alanine aminotransferase(ALT)and CD4+T human immunodeficiency virus(HIV)-positive pregnant women.METHODS The data of 80 HIV-positive pregnant women who were treated in Haikou Maternal and Child Health Hospital from May 2015 to May 2017 were retrospectively analyzed,40 HIV-positive pregnant women who were consistently treated with highly active antiretroviral therapy(HAART)after delivery were assigned as the treatment group,while 40 HIV-positive pregnant women who stopped being treated with HAART after delivery were set as the control group.A 2-year follow-up was conducted to observe and record the effect of mother-to-child blocking therapy,and the levels of HGB and ALT as well as CD4+T counts were observed and compared between the two groups after the delivery for 6,12,18 and 24 months.RESULTS There was no significant difference in the effective rate of mother-to-child blocking between the two group.In the treatment group,there were significant differences in the HGB,ALT and CD4+T gestational age of 36 weeks and after the delivery for 6,12,18 and 24 months(P<0.001);in the control group,there were significant differences in the HGB,ALT and CD4+T gestational age of 36 weeks and after the delivery for 6,12,18 and 24 months(P<0.001).The HGB level of the two groups was significantly higher after the delivery for 6,12,18 and 24 months than at the gestational age of 36 weeks(P<0.05);the ALT level of the treatment group was significantly higher after the delivery for 6,12,18 and 24 months than at the gestational age of 36 weeks(P<0.05),the ALT level of the treatment group was significantly higher than of the control group after the delivery for 6 and 12 months(P<0.05),the ALT level of the treatment group was significantly lower than that of the control group after the delivery for 18 and 24 months(P<0.05).The CD4+T counts of the treatment group were significantly greater after the delivery for 6,12,18 and 24 months than at t

关 键 词：艾滋病 人类免疫缺陷病毒 血红蛋白 谷丙转氨酶 

分 类 号：R512.91[医药卫生—内科学]