乙型肝炎病毒母婴阻断的临床效果及其影响因素分析

Clinical effect of prevention of mother-to-child transmission of HIV and the influencing factors analysis

目的探讨乙型肝炎病毒(HBV)母婴阻断的临床效果及影响因素分析。方法选取建德市第一人民医院2012年1月—2015年6月收治的乙肝表面抗原(HBs Ag)阳性母亲及其所生产的婴幼儿482例,收集母亲的年龄、乙肝e抗原(HBe Ag)状态、乙肝病毒基因(HBV-DNA)载量及婴幼儿的Apgar评分、分娩方式、喂养方式等情况。结果在482例母亲所生的婴幼儿中,乙肝母婴阻断成功率为95.65%。将乙肝母婴阻断成功461例为成功组,未成功21例为未成功组,两组患者分娩方式、喂养方式及Apgar评分比较,差异无统计学意义(P>0.05);成功组患者母体感染状态、HBV-DNA载量情况优于未成功组(P<0.05)。多因素logistic回归分析结果显示,HBe Ag阳性和HBV-DNA高载量是HBV母婴阻断失败的影响因素(P<0.05)。结论 HBe Ag阳性和HBV-DNA高载量是HBV母婴阻断失败的主要影响因素。

Objective To evaluate the clinical effect of prevention of mother-to-child transmission of HIV and the influencing factors analysis. Methods A total of 482 cases of HBs Ag positive mothers and their infants were selected from January 2012 to June 2015 in the First People＇s Hospital of Jiande as research objects,analysed the ages,HBeAg status of mothers and theApgar scores,delivery modes and feeding methods of infants. Results In 482 cases of infants,the success rate of prevention of mother-to-child transmission was 95. 65%. The 461 cases of successfully prevention of mother-to-child transmission as success group,the 21 cases as failed group,no statistically significant difference of Apgar scores,delivery modes or feeding methods was found between the two groups（ P〉0. 05）; the HBeAg status,HBV-DNA capacity of success group were better than failed group（ P〈0. 05）. Multivariate logistic regression analysis showed that HBs Ag positive,high HBV-DNA capacity were the influnce factors of failed of prevention of mother-to-child transmission of HIV（ P〈0. 05）. Conclusion HBs Ag positive,high HBV-DNA capacity were the influnce factors of failed of prevention of mother-to-child transmission of HIV.