【摘要】：目的分析經(jīng)艾滋病母嬰阻斷治療(PMTCT)艾滋病病毒(HIV)陽性孕產(chǎn)婦,產(chǎn)后的臨床體征、血色素、肝功能及免疫功能變化情況,為進(jìn)一步指導(dǎo)艾滋病母嬰阻斷工作提供科學(xué)治療依據(jù)。方法對(duì)廣西2004-2010年76例經(jīng)PMTCT的HIV陽性孕產(chǎn)婦,在產(chǎn)后2年定期隨訪,其中31例產(chǎn)后繼續(xù)接受高效抗反轉(zhuǎn)錄病毒治療(HAART),45例產(chǎn)后停止HAART,對(duì)比分析她們的臨床體征及實(shí)驗(yàn)室檢測的血色素(HGB)、中性粒細(xì)胞(NC)、肝功能(ALT)和免疫功能[CD+4T淋巴細(xì)胞(簡稱CD4細(xì)胞)]的變化。結(jié)果在31例產(chǎn)后服藥的孕產(chǎn)婦中,4例在產(chǎn)后平均2年后出現(xiàn)司坦夫定(D4T)藥物關(guān)聯(lián)的體型改變,2例自產(chǎn)后1年內(nèi)出現(xiàn)嚴(yán)重的齊多夫定(AZT)貧血;45例產(chǎn)后停藥者未出現(xiàn)相關(guān)臨床體征。31例產(chǎn)后服藥的孕產(chǎn)婦,在產(chǎn)后2年內(nèi)CD4細(xì)胞計(jì)數(shù)比PMTCT前有顯著性提高。45例產(chǎn)后停藥的孕產(chǎn)婦,其CD4細(xì)胞計(jì)數(shù)在產(chǎn)后1年以后有顯著性下降。31例產(chǎn)后服藥和45例產(chǎn)后停止服藥的孕產(chǎn)婦,產(chǎn)后2年定期隨訪HGB,NC,ALT均無顯著性變化。結(jié)論廣西孕產(chǎn)婦在服用AZT藥后,對(duì)部分孕產(chǎn)婦血色素影響明顯,部分孕產(chǎn)婦服用D4T治療2年后有脂肪轉(zhuǎn)移嚴(yán)重不良反應(yīng)。艾滋病母嬰阻斷后停藥的孕產(chǎn)婦CD4細(xì)胞水平下降較快。在艾滋病母嬰阻斷后停藥或繼續(xù)服藥的孕產(chǎn)婦,其產(chǎn)后2年內(nèi)的HGB、NC、ALT影響不明顯。
[Abstract]:Objective to analyze the changes of clinical signs, hemoglobin, liver function and immune function in pregnant and parturient women with (PMTCT) HIV (HIV) positive treatment by maternal and infant block, and to provide scientific treatment basis for further guiding the work of maternal and infant AIDS blocking. Methods 76 cases of HIV positive pregnant and lying-in women with PMTCT in Guangxi from 2004 to 2010 were followed up regularly in 2 years postpartum. Among them, 31 cases continued to receive highly effective antiretrovirals after delivery (HAART), 45 cases stopped postpartum HAART, comparative analysis of their clinical signs and laboratory detection of hemoglobin (HGB), neutrophil (NC), liver function (ALT) and immune function [CD 4T lymphocyte] (CD4 cells). Results among 31 postpartum drug taking pregnant women, 4 cases had D4T associated body changes after postpartum on average 2 years, 2 cases had severe zidovudine (AZT) anemia within 1 year after delivery, and 45 cases of postpartum drug withdrawal did not appear. Related clinical signs. 31 pregnant and parturient women taking drugs after delivery, The count of CD4 cells in postpartum women was significantly higher than that before PMTCT. The count of CD4 cells in 45 pregnant women who stopped taking drugs after postpartum was significantly decreased after 1 year postpartum. There were 31 cases of postpartum drug taking and 45 cases of postpartum women who stopped taking drugs. There was no significant change in HGB,NC,ALT during 2 years postpartum follow-up. Conclusion the hemoglobin of some pregnant and lying-in women in Guangxi was significantly affected after taking AZT, and some pregnant and lying-in women had serious adverse reactions of fat metastasis after 2 years of treatment with D4T. The CD4 cell level of pregnant and parturient who stopped taking drugs after blocking the mother and infant of AIDS decreased rapidly. The effect of HGB,NC,ALT was not obvious in the pregnant women who stopped taking drugs or continued to take drugs after the interruption of mother and child AIDS within 2 years postpartum.
【作者單位】： 廣西壯族自治區(qū)疾病預(yù)防控制中心;
【分類號(hào)】：R512.91

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