中华预防医学杂志
中華預防醫學雜誌
중화예방의학잡지
CHINESE JOURNAL OF
2011年
10期
912-915
,共4页
何艳%罗艳%丁依玲%郑煜煌%李靖%黄健%李介民
何豔%囉豔%丁依玲%鄭煜煌%李靖%黃健%李介民
하염%라염%정의령%정욱황%리정%황건%리개민
疾病传播,垂直%HIV%高效抗逆转录病毒治疗%胚胎发育
疾病傳播,垂直%HIV%高效抗逆轉錄病毒治療%胚胎髮育
질병전파,수직%HIV%고효항역전록병독치료%배태발육
Disease transmission,vertical%HIV%Highly active antiretroviral therapy (HAART)%Embryonic development
目的 研究高效抗逆转录病毒治疗(HAART)阻断母婴HIV传播及对婴儿生长发育的影响。方法 2005年5月至2010年6月在某医院感染科和妇产科选择HIV感染的确诊育龄妇女及孕妇16例，观察其分娩的17名新生儿为实验组。孕前或妊娠14～28周开展HAART抗病毒治疗。治疗方案：齐多夫定(AZT)0.3∥次（每日2次）+拉米夫定(3TC)0.3 g/次（每日1次）+奈韦拉平( NVP)0.2 g/次（每日2次）或依非韦伦(EFV)0.6 g/次，每日1次，并进行分娩干预和新生儿人工喂养。选取同期分娩的正常婴儿16名为对照组。观察婴幼儿生长发育指标至18个月，同时检测新生儿期和12个月龄时的血红蛋白(Hb)、肝肾功能及血清铁和钙。结果 孕妇一般状况良好，对药物有较好的耐受性。实验组新生儿体重、身长、Apgar评分分别为(3.5 ±0.9) kg、(54.2±3.8)cm、7～10分，对照组分别为(3.6±0.8)kg、(55.6±3.6)cm、8～10分(t体重=1.01，t身长=6.98，P值均＞0.05)；12个月龄时实验组体重、身高分别为(9.4±1.8) kg、(76.3±2.7) cm，对照组分别为(9.9±2.5)kg、(76.8±2.9) cm（t体重=0.83，t身长=1.00，P值均＞0.05）。新生儿期实验组Hb含量为(126.2±16.7)g/L，对照组为(148.6±20.5)g/L(t=-5.89，P=0.11)。12个月龄时，实验组Hb含量为( 125.9±19.8)g/L，对照组为(130.1±18.7)g/L;实验组总胆红素(TB)为(11.7±3.5) μmol/L，对照组为(13.2±3.7) μmol/L（tHb=- 3.82，tTB=-2.14，P值均＞0.05）。新生儿期和12个月龄时实验组血清铁和钙分别为(25.4±5.7)、(26.4±7.2)μmol/L和(2.3±0.6)、(2.8±0.6) mol/L，对照组分别为(26.2±4.9)、(28.1±6.9) μmol/L和(2.6±0.5)、(3.1±0.5) mol/L(新生儿期：t铁 =0.80，t钙= -3.00，P值均＞0.05；12个月龄时：t铁=- 1.50，t钙=-1.00,P值均＞0.05)。监测18个月时显示所有HIV阳性母亲所生婴儿均无HIV感染。结论 接受HAART治疗的孕妇不仅可阻断HIV母婴传播，而且在观察期内未发现对婴儿生长发育有影响。
目的 研究高效抗逆轉錄病毒治療(HAART)阻斷母嬰HIV傳播及對嬰兒生長髮育的影響。方法 2005年5月至2010年6月在某醫院感染科和婦產科選擇HIV感染的確診育齡婦女及孕婦16例，觀察其分娩的17名新生兒為實驗組。孕前或妊娠14～28週開展HAART抗病毒治療。治療方案：齊多伕定(AZT)0.3∥次（每日2次）+拉米伕定(3TC)0.3 g/次（每日1次）+奈韋拉平( NVP)0.2 g/次（每日2次）或依非韋倫(EFV)0.6 g/次，每日1次，併進行分娩榦預和新生兒人工餵養。選取同期分娩的正常嬰兒16名為對照組。觀察嬰幼兒生長髮育指標至18箇月，同時檢測新生兒期和12箇月齡時的血紅蛋白(Hb)、肝腎功能及血清鐵和鈣。結果 孕婦一般狀況良好，對藥物有較好的耐受性。實驗組新生兒體重、身長、Apgar評分分彆為(3.5 ±0.9) kg、(54.2±3.8)cm、7～10分，對照組分彆為(3.6±0.8)kg、(55.6±3.6)cm、8～10分(t體重=1.01，t身長=6.98，P值均＞0.05)；12箇月齡時實驗組體重、身高分彆為(9.4±1.8) kg、(76.3±2.7) cm，對照組分彆為(9.9±2.5)kg、(76.8±2.9) cm（t體重=0.83，t身長=1.00，P值均＞0.05）。新生兒期實驗組Hb含量為(126.2±16.7)g/L，對照組為(148.6±20.5)g/L(t=-5.89，P=0.11)。12箇月齡時，實驗組Hb含量為( 125.9±19.8)g/L，對照組為(130.1±18.7)g/L;實驗組總膽紅素(TB)為(11.7±3.5) μmol/L，對照組為(13.2±3.7) μmol/L（tHb=- 3.82，tTB=-2.14，P值均＞0.05）。新生兒期和12箇月齡時實驗組血清鐵和鈣分彆為(25.4±5.7)、(26.4±7.2)μmol/L和(2.3±0.6)、(2.8±0.6) mol/L，對照組分彆為(26.2±4.9)、(28.1±6.9) μmol/L和(2.6±0.5)、(3.1±0.5) mol/L(新生兒期：t鐵 =0.80，t鈣= -3.00，P值均＞0.05；12箇月齡時：t鐵=- 1.50，t鈣=-1.00,P值均＞0.05)。鑑測18箇月時顯示所有HIV暘性母親所生嬰兒均無HIV感染。結論 接受HAART治療的孕婦不僅可阻斷HIV母嬰傳播，而且在觀察期內未髮現對嬰兒生長髮育有影響。
목적 연구고효항역전록병독치료(HAART)조단모영HIV전파급대영인생장발육적영향。방법 2005년5월지2010년6월재모의원감염과화부산과선택HIV감염적학진육령부녀급잉부16례，관찰기분면적17명신생인위실험조。잉전혹임신14～28주개전HAART항병독치료。치료방안：제다부정(AZT)0.3∥차（매일2차）+랍미부정(3TC)0.3 g/차（매일1차）+내위랍평( NVP)0.2 g/차（매일2차）혹의비위륜(EFV)0.6 g/차，매일1차，병진행분면간예화신생인인공위양。선취동기분면적정상영인16명위대조조。관찰영유인생장발육지표지18개월，동시검측신생인기화12개월령시적혈홍단백(Hb)、간신공능급혈청철화개。결과 잉부일반상황량호，대약물유교호적내수성。실험조신생인체중、신장、Apgar평분분별위(3.5 ±0.9) kg、(54.2±3.8)cm、7～10분，대조조분별위(3.6±0.8)kg、(55.6±3.6)cm、8～10분(t체중=1.01，t신장=6.98，P치균＞0.05)；12개월령시실험조체중、신고분별위(9.4±1.8) kg、(76.3±2.7) cm，대조조분별위(9.9±2.5)kg、(76.8±2.9) cm（t체중=0.83，t신장=1.00，P치균＞0.05）。신생인기실험조Hb함량위(126.2±16.7)g/L，대조조위(148.6±20.5)g/L(t=-5.89，P=0.11)。12개월령시，실험조Hb함량위( 125.9±19.8)g/L，대조조위(130.1±18.7)g/L;실험조총담홍소(TB)위(11.7±3.5) μmol/L，대조조위(13.2±3.7) μmol/L（tHb=- 3.82，tTB=-2.14，P치균＞0.05）。신생인기화12개월령시실험조혈청철화개분별위(25.4±5.7)、(26.4±7.2)μmol/L화(2.3±0.6)、(2.8±0.6) mol/L，대조조분별위(26.2±4.9)、(28.1±6.9) μmol/L화(2.6±0.5)、(3.1±0.5) mol/L(신생인기：t철 =0.80，t개= -3.00，P치균＞0.05；12개월령시：t철=- 1.50，t개=-1.00,P치균＞0.05)。감측18개월시현시소유HIV양성모친소생영인균무HIV감염。결론 접수HAART치료적잉부불부가조단HIV모영전파，이차재관찰기내미발현대영인생장발육유영향。
Objective To identify the effect of highly active anti-retroviral therapy (HAART) onprevention of mother to child transmission (PMTCT) of HIV and on infant growth and development.Methods A total of 16 HIV-infected women or pregnant women selected in this study received HAARTbefore or 18 -24 weeks after pregnancy. The treatment included taking Zidovudine(AZT) 0. 3 g each time,twice a day,Lamivudine (3TC) 0. 3 g each time,once a day and Nevirapine(NVP) 0. 2 g each time,twice aday or Efavirenz(EFV) 0. 6 g each time,once a day,as well as labor intervention and artificial feeding. Thegrowth index for 17 infants from HIV-infected mothers( experimental group) and 16 normal infants (controlgroup) were observed for 18 months. Neonatal emoglobin (Hb), liver and kidney function, serum iron andcalcium were detected at neonatal period and at 12th month,respectively. Results All the pregnant womenwere in good conditions and had tolerance with HAART. The birth weight, length and Apgar score of thenewborns in the experimental group were( 3. 5 ± 0. 9)kg, (54. 2 ± 3. 8 )cm and 7 -10 scores respectively,however those in the control group were (3.6 ± 0. 8 ) kg, ( 55.6 ± 3.6 ) cm and 8 - 10 scores ( t weight = 1.01,tlength, = 6. 98, P ＞ 0. 05 ). Weight and length of infants in experimental group were ( 9.36 ± 1.8 ) kg and (76.3 ±2.7)cm at 12th month,while those in control group were(9. 86 ±2.5) kg and(76.8 ±2.9)cm ( tweight = 0. 83, tlength = 1.00, P ＞ 0. 05 ). The level of Hb in experimental group was ( 126. 2 ± 16. 7) g/L, and was ( 148.6 ± 20. 5 ) g/L in control group ( t = - 5. 89, P = 0. 11 ). At 1 2th month, the levels of Hb and the total bilirubin (TB) were ( 125.9 ± 19. 8 ) g/L and ( 11.7 ± 3.5 ) μmol/L in experimental group; and those in the control group were( 130. 1 ± 18. 7) g/L and( 13.2 ± 3. 7) μmol/L(tHb = - 3. 82,tTB = - 2. 14,P＞0. 05 ). Serum iron and calcium were (25.4 ±5.7) μmol/L and (26. 4 ±7. 2) μmol/L at neonatal period and were(2. 3 ± 0. 6) mol/L and (2. 8 ± 0. 6) mol/L at 12th month in experimental group, while those were (26. 2 ±4. 9) μmol/L and (28. 1 ±6. 9) μmol/L at neonatal period and were(2. 6 ±0. 5) mol/L and(3. 1 ±0. 5) mol/L at 12th month in the control group(tFe =0. 80 and tCa = -3.00 in neonatal period,tFe = - 1.50and tCa = -1.00 at 12th month, P ＞ 0. 05). All infants of HIV-infected mothers were not infected with HIV when they were 18 months old. ConclusionHAART can prevent mother to child transmission of HIV and it was not found to influence the baby's growth and development in this study.
