抗病毒药物预防艾滋病母婴传播的效果研究

发布时间：2018-01-30 10:20

本文关键词： 抗病毒治疗艾滋病母婴阻断效果　出处：《安徽医科大学》2015年硕士论文　论文类型：学位论文

【摘要】：目的:了解杭州市某三甲医院HIV感染孕产妇接受抗病毒药物预防艾滋病母婴传播以及所生新生儿HIV感染情况,评价其阻断方案的有效性,安全性,以及不良反应,寻求最佳阻断方案,为今后更好的开展预防艾滋病母婴传播提供参考。方法:选择2007年7月-2013年12月杭州市某三甲医院门诊检查并住院分娩的HIV阳性妊娠妇女98例,以HIV孕产妇抗病毒时间不同分孕14周、孕28周、临产三组:A组40例,B组38例,C组20例。用药方案:A组:孕妇从14周开始服用AZT+3TC+NVP方案至分娩结束;B组:孕妇从28周开始服用AZT+3TC+NVP方案至分娩结束;C组:NVP方案,限于孕期没有接受HIV检查,临产才发现艾滋病感染的孕妇。所有新生儿出生6~12h内服用AZT糖浆,每天二次,至出生后6周。孕妇抗病毒前后分别检测CD4+细胞数量,血常规,肝功能的指标。孕妇采用安全助产措施和新生儿护理阻断措施,分娩新生儿99人,分别于12个月、18个月进行新生儿HIV抗体检测,并分析结果。结果:孕妇在抗病毒前CD4+低于正常值共10例,抗病毒后三组孕妇CD4+细胞数量均在正常范围,三组相比抗病毒前和抗病毒后CD4+细胞数量变化差异无统计学意义(P0.05)。孕妇抗病毒服药期间依从性好,不良反应少,主要为胃肠道反应,轻度贫血,肝功能轻度损害,无其他重大不良反应发生。新生儿HIV感染情况比较:A组婴儿0感染,B组2例婴儿感染,C组4例婴儿感染,三组新生儿阻断效果:A组和B组比较,X~2=0.97差异无统计学意义(P0.05),B组和C组比较,X~2=1.685,P=0.0194,差异有统计学意义(P0.05),A组和C组比较,X~2=5.815,P=0.016差异有统计学意义(P0.05)。A组和B组阻断效果明显优于C组。结论:三联抗病毒药物对于阻断HIV母婴传播效果非常显著,建议及早抗病毒治疗,婴儿HIV感染率更低,新生儿分娩后需加强随访和管理。
[Abstract]:Objective: to investigate the prevention of mother-to-child transmission of HIV and neonatal HIV infection by antiviral drugs in pregnant women infected with HIV in a third class hospital in Hangzhou, and to evaluate the efficacy and safety of the blocking regimen. And adverse reactions to seek the best blocking scheme. To provide a reference for the prevention of mother-to-child transmission of HIV in the future. Methods:. From July 2007 to December 2013 98 pregnant women with HIV positive pregnancy were selected for outpatient examination and in-patient delivery in a third Class Hospital in Hangzhou. The antiviral time of HIV pregnant women was divided into 14 weeks, 28 weeks, and 38 cases in group B, 40 cases in group A and 40 cases in group B, respectively. Group C (n = 20): group A: pregnant women received AZT 3TC NVP from 14 weeks to the end of delivery. Group B: pregnant women received AZT 3TC NVP regimen from 28 weeks to the end of delivery; Group C: NVP regimen, limited to pregnant women who did not undergo an HIV test during pregnancy and found HIV infection immediately before delivery. All newborns were given AZT syrup twice a day within 612 hours of birth. At 6 weeks after birth, the number of CD4 cells, blood routine and liver function were detected before and after antiviral treatment. The pregnant women adopted safe midwifery and neonatal nursing blocking measures to deliver 99 newborns. Neonatal HIV antibody was detected in 12 months and 18 months, and the results were analyzed. Results: 10 cases of pregnant women had CD4 lower than normal before anti-virus. The number of CD4 cells in the three groups was in the normal range after antiviral therapy. There was no significant difference in the number of CD4 cells between the three groups before and after antiviral therapy. Pregnant women had good compliance and less adverse reactions during the period of antiviral medication, mainly gastrointestinal reactions. There were mild anemia, mild damage of liver function and no other major adverse reactions. The infection of HIV in neonates was compared with that in group B (n = 2) and group B (n = 2). There were 4 cases in group C (n = 4). There was no significant difference between group A and group B (P 0.05) and group C (P 0.05), and there was no significant difference between group A and group B (P 0.05) and group C (n = 1. 685), and there was no significant difference between group A and group B (P 0.05) and group C (P < 0.05). The difference was statistically significant between group A and group C (P 0.05). The blocking effect of group A and group B was significantly better than that of group C. conclusion: the effect of triple antiviral drugs on blocking HIV mother-to-child transmission is very significant. It is suggested that early antiviral therapy can lower the infection rate of HIV in infants, and the follow-up and management should be strengthened after delivery.
【学位授予单位】：安徽医科大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R512.91

【相似文献】