妊娠合并艾滋病孕期抗病毒治疗研究

目的观察妊娠合并艾滋病孕期抗病毒治疗的临床疗效。方法选择2016年5月至2018年5月本院收治的妊娠合并AIDS患者52例为观察对象,以随机化原则分为对照组(26例,采纳单药或者双药抗逆转录病毒治疗)和研究组(26例,采纳高效抗逆转录病毒治疗),比较妊娠结局、新生儿结局。结果研究组阴道分娩率(84.62%)显著较对照组(57.69%)高,剖宫产率(15.38%)显著较对照组(42.31%)低,P<0.05,具统计学差异。研究组新生儿感染(7.69%)、窒息(3.85%)、新生儿HIV阳性率(7.69%)显著较对照组(30.77%、34.62%、34.62%)低,研究组新生儿Apgar评分显著较对照组高,P<0.05,具统计学差异。结论高效抗逆转录病毒疗法可有效改善妊娠合并AIDS患者分娩结局,效果显著,值得借鉴。

孕期抗病毒治疗结合标准阻断措施对乙型肝炎高病毒载量孕妇所生婴儿母婴传播阻断的影响

探讨乙型肝炎高病毒载量孕妇应用孕期抗病毒干预、标准阻断干预的意义。方法 选择2019年全年期间收取的1875例乙型肝炎高病毒载量孕妇。另选取2020年全年收治的乙型肝炎高病毒载量孕妇(1875例)。依次作为对照组、观察组前者930例,以标准阻断方案进行处理,观察组945例联用孕期抗病毒治疗。结果 观察组新生儿免疫成功率97.23%,大于对照组90.72%(P<0.05)。观察组重症肝炎发生率0.64%、非生育住院率10.08%、终止妊娠率4.37%均小于对照组10.72%、4.16%、24.16%、13.28%(P<0.05)。结论 孕期抗病毒治疗与标准阻断措施联合可有效治疗乙型肝炎高病毒载量孕妇,可阻断母婴传播,改善妊娠结局。

Management of chronic hepatitis B in pregnancy

Pregnancy associated with chronic hepatitis B (CHB) is a common and important problem with unique challenges. Pregnant women infected with CHB are different from the general population, and their special problems need to be considered: such as the effect of hepatitis B virus (HBV) infection on the mother and fetus, the effect of pregnancy on replication of the HBV, whether mothers should take HBV antiviral therapy during pregnancy, the effect of these treatments on the mother and fetus, how to carry out immunization of neonates, whether it can induce hepatitis activity after delivery and other serious issues. At present, there are about 350 million individuals with HBV infection worldwide, of which 50% were infected during the perinatal or neonatal period, especially in HBV-endemic countries. Currently, the rate of HBV infection in thechild-bearing age group is still at a high level, and the infection rate is as high as 8.16%. Effective prevention of mother-to-child transmission is an important means of reducing the global burden of chronic HBV infection. Even after adopting the combined immunization measures, there are still 5%-10% of babies born with HBV infection in hepatitis B e antigen positive pregnant women. As HBV perinatal transmission is the main cause of chronic HBV infection, we must consider how to prevent this transmission to reduce the burden of HBV infection. In this population of chronic HBV infected women of childbearing age, specific detection, intervention and follow-up measures are particularly worthy of attention and discussion.