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目的通过检索国内外相关文献,分析几种针对艾滋病病毒(HIV)感染孕妇常用的预防母婴传播(PMTCT)措施的有效性。方法计算机检索万方数据库、维普期刊资源整合服务平台、CNKI、PubMed、SpringerLink、中国生物医学文献数据库等,检索时限为数据库建库起至2016年5月,查找所有相关文献,并追溯其原始文献及参考文献,经过逐层筛选后,使用Revman 5.2软件进行Meta分析。结果最终纳入15篇随机对照研究(RCT)或高质量对照研究文献,其中7篇文献对比了单一用药与空白对照组,6篇文献对单一用药及三联用药进行了对比,5篇文献将自然分娩与剖宫产进行了对比。Meta分析结果提示:单一抗病毒药物相对未服用抗病毒药物[比值比(OR)=2.71,95%可信区间(CI):2.10~3.49),P<0.000 01]、三联用药相对单一用药(OR=2.72,95%CI:1.84~4.02,P<0.000 01)及剖宫产相对自然分娩[相对危险度(RR)=1.61,95%CI:1.15~2.25,P=0.005]均能降低感染风险。结论规律的抗病毒治疗及选择剖宫产分娩均能够有效地降低母婴传播率,其中三联用药的效果优于单一用药。合理的抗病毒治疗、安全的分娩方式是阻断HIV母婴传播的重要措施。
OBJECTIVE: To search for the effectiveness of several commonly used strategies for the prevention of mother-to-child transmission (PMTCT) in pregnant women infected with HIV by searching relevant literature both at home and abroad. Methods We searched Wanfang database, VIP journal resources integration service platform, CNKI, PubMed, SpringerLink and China Biomedical Literature Database. The retrieval time was from database construction to May, 2016. All relevant documents were searched and their original documents were traced back And references, after layer by layer screening, using Revman 5.2 software for meta-analysis. Results A total of 15 randomized controlled trials (RCTs) or high-quality control studies were included. Of these, 7 articles compared single-agent with blank controls and 6 articles compared single-agent and triple-drug regimens. Five articles reported spontaneous labor Contrasted with cesarean section. The results of Meta-analysis suggested that single antiviral drugs were not associated with antiviral drugs (odds ratio (OR) = 2.71, 95% CI: 2.10 to 3.49, P <0.000 01] OR = 2.72, 95% CI: 1.84-4.02, P <0.000 01) and cesarean delivery relative to natural delivery [relative risk (RR) = 1.61, 95% CI: 1.15-2.25, P = 0.005] risk. Conclusion Regular antiviral therapy and selective cesarean delivery can effectively reduce the mother-to-infant transmission rate. The effect of triple therapy is better than that of single drug treatment. Reasonable antiviral treatment, safe delivery mode is an important measure to block the mother-to-child transmission of HIV.