阿昔洛韦联合静注人免疫球蛋白对妊娠晚期合并水痘患者的疗效及其影响因素分析  

Analysis of the effects and influencing factors of acyclovir combined with intravenous human immunoglobulin in treating pregnant women with varicella during late pregnancy

作　　者：徐征洪 胡志亮 韩国荣 陈艳[1] 丁祎 XU Zhenghong;HU Zhiliang;HAN Guorong;CHEN Yan;DING Yi(Obstetrics and Gynecology,Nanjing Hospital Affiliated to Nanjing University of Traditional Chinese Medicine/Nanjing Second Hospital,Nanjing 210003,China;Department of Infection,Nanjing Hospital Affiliated to Nanjing University of Traditional Chinese Medicine/Nanjing Second Hospital,Nanjing 210003,China)

机构地区：[1]南京中医药大学附属南京医院/南京市第二医院妇产科,江苏南京210003 [2]南京中医药大学附属南京医院/南京市第二医院感染科,江苏南京210003

出　　处：《现代医学》2023年第3期334-339,共6页Modern Medical Journal

基　　金：南京市卫生科技发展资金项目(ZKX21037)。

摘　　要：目的:分析阿昔洛韦联合静注人免疫球蛋白对妊娠晚期并发水痘孕妇的疗效,以及该方案对患者妊娠结局的影响。方法:收集2018年1月至2020年12月我院妊娠晚期合并水痘的孕妇48例,将其分为对照组(n=24)与观察组(n=24),对照组仅用阿昔洛韦治疗,观察组采用阿昔洛韦联合静注人免疫球蛋白治疗,应用单因素和多重线性回归的方法对数据进行分析。结果:观察组的疗效显著优于对照组。单因素分析结果显示,两组患者在疱疹结痂时间、热程、并发症发生率比较差异有统计学意义(P<0.05),而年龄、发病孕周和分娩孕周比较差异无统计学意义(P>0.05)。多重线性回归分析结果显示,疱疹结痂时间与治疗方法呈负相关(B=-1.159,P<0.05),与热程呈正相关(B=0.648,P<0.05);热程与疱疹结痂时间呈正相关(B=0.304,P<0.05),与治疗方法呈负相关(B=-1.285,P<0.05)。结论:阿昔洛韦联合静注人免疫球蛋白治疗可提升抗病毒作用,缩短热程和疱疹结痂时间,并降低并发症发生率,减轻临床症状。在确保母婴安全的情况下,应尽量推迟分娩,以预防新生儿水痘的发生。Objective:Investigation of the efficacy of acyclovir combined with intravenous human immunoglobulin in the treatment of varicella complicating late pregnancy and analysis of the impact of this regimen on pregnancy outcomes.Methods:48 pregnant women with varicella in our hospital from January 2018 to December 2020 were collected and divided into control group(acyclovir,n=24)and observation group(acyclovir+intravenous human immunoglobulin,n=24),univariate and multiple linear regression methods were applied to analyze the outcome of treatment for varicella.Results:The efficacy of the observation group was significantly higher than that of the control group.Univariate analysis showed that there were statistically significant differences between the two groups in terms of time to herpes crusting,heat course and complication rate(P<0.05),while there were no significant differences in age,gestational week of onset and gestational week of delivery.Multiple linear regression analysis showed that the time to herpes crusting was positively correlated with heat course(B=0.648,P<0.05),while negatively correlated with treatment method(B=-1.159,P<0.05).When using heat course as the dependent variable,the results indicated a positive correlation with time to herpes crusting(B=0.304,P<0.05)and a negative correlation with treatment method(B=-1.285,P<0.05).Conclusions:Treatment with acyclovir combined with intravenous human immunoglobulin enhances the antiviral effect,shortens the duration of fever and herpes crusting,and reduces complications and relieves clinical symptoms.Delivery should be delayed as much as possible to prevent chickenpox in newborns while ensuring maternal and infant safety.

关 键 词：水痘 妊娠结局 阿昔洛韦 静注人免疫球蛋白 新生儿水痘 

分 类 号：R714.251[医药卫生—妇产科学]