人类免疫缺陷病毒感染母婴传播阻断临床探讨

Investigation of interruption of mother-to-child transmission among HIV-infected women

目的:探讨人类免疫缺陷病毒(HIV)感染母婴传播的阻断方法与效果。方法:回顾性分析2009年6月至2012年6月在我院分娩的110例HIV阳性孕妇的临床资料。通过采取抗病毒治疗、选择性剖宫产和人工喂养等措施进行母婴阻断,比较CD4+T淋巴细胞计数>200个/μL组和<200个/μL组的不同妊娠结局。观察婴儿出生后18个月龄以上HIV抗体情况。结果:(1)110例HIV阳性孕妇实行药物阻断102例,阻断率92.72%,分娩方式选择剖宫产106例,阻断率96.36%,112例新生儿全部实行人工喂养,阻断率100%。(2)CD4+T淋巴计数分为>200个/μL组(84例)和<200个/μL组(26例),CD4+T淋巴细胞计数>200个/μL组中,贫血、早产和产后出血发生率均低于<200个/μL组;新生儿低体重儿和FGR的发生率明显低于<200个/μL组,两组对比差异有显著性。(3)112例婴幼儿均已满18个月,定期随访88例,随访率78.58%,随访的88例婴儿HIV抗体均为阴性。结论:人类免疫缺陷病毒(HIV)母婴阻断措施是控制儿童艾滋病流行的重要措施。

Objective To study the method and effectiveness of interruption of mother-to-child transmission among human immunodeficiency virus（HIV）-infected women. Methods Clinical information of 110 cases of HIV-infected pregnant women who gave birth in the eighth municipal hospital of Guangzhou from June 2009 to June 2012 were retrospectively analyzed. Measures such as antiviral treatment, elective caesarean and artificial feeding were taken to interupt mother- to- child transmission, differences in pregnancy outcomes bewteen CD4t- lymphocyte count 200 / μL and 200 / μL groups were compared, and whether the baby had HIV antibodies after 18 months of age was tested. Results Among 110 cases of HIV-infected pregnant women, 102 cases accepted drugs block, the blocking rate was 92.72%, 106 cases accepted elective caesarean, the block rate was96.36%, all of the 112 cases of newborns accepted artificial feeding, the block rate was 100%. The cases were divided into two groups according to CD4 T lymphoma count ： group 1 [ 〉200 / μL（84 cases） ] and group 2[ 200 / μL group（26 cases） ]. In group 1, the rate of anemia, preterm and postpartum hemorrhage was lower than that of group 2; the rate of low birth weight and FGR was obviously lower than that of group 2. There was statisticsly significantly difference between the two groups. 112 infants were all aged 18 months, among those we regularly followed up 88 cases（78.58%） and no infants were HIV-infected. Conclusion Interruptions of mother-to-child transmission of HIV are important measures to control AIDS epidemic among children.