HIV/AIDS合并血小板减少患者HAART后血小板复常的特征及影响因素分析

摘要

目的 分析HIV/AIDS合并血小板减少患者在高效抗逆转录病毒治疗(highly active antiretroviral therapy,HAART)后血小板的复常特征,探讨影响复常的相关因素.方法 采用回顾性分析,以2003年6月—2015年12月在北京地坛医院进行抗病毒治疗的132例HIV/AIDS合并血小板减少的患者为研究对象,分析患者HAART 4周和24周后血小板的复常率及基本特征.结果 ①132例患者中血小板轻度减少99例(75.00%),中度减少19例(14.39%),重度减少14例(10.61%).患者HAART 4周、24周后血小板的复常率分别为63.9%、80.8%,差异具有统计学意义(P=0.003).②单因素Logistic分析提示通过血液传播(OR=4.632,P=0.024),合并HBsAg阳性(OR=3.829,P=0.024)及合并抗HCV阳性(OR=6.476,P=0.020)是影响血小板复常的因素,多因素Logistic分析提示合并HBsAg阳性(OR=4.345,P=0.027)是影响血小板复常的因素.结论 HAART为HIV/AIDS合并血小板减少最有效的方法,尽早HAART可避免血小板持续降低.HBsAg阳性是影响血小板复常的主要因素.对于存在危险因素的患者应该给予重视,尽早做出干预措施.%Objective To analyze the normalization characteristics of thrombocyte on HIV/AIDS patients with thrombocytopenia after the HAART given to them, and to investigate the influence factors.Methods Total of 132 HIV/AIDS patients with thrombocytopenia hospitalized in Ditan hospital from June 2003 to December 2015 were treated by HAART. The normalization rate of thrombocyte and its characteristics were analyzed retrospectively on the time of 4 weeks and 24 weeks after the HARRT. Results Among 132 patients, 99 (75.00%) were mild thrombocytopenia, and 19 (14.39%) and 14 (10.61%) were moderate and sever thrombocytopenia, respectively. The normalization rate of platelet was 63.9% and 80.8% respectively after the patients having received HAART for 4 weeks and 24 weeks. The difference was statistically significant (P=0.003). Univariate logistic regression analysis suggested that the transmission via blood(OR=4.632,P=0.024), HBsAg positive(OR=3.829,P=0.024) and anti-HCV positive(OR=6.476,P=0.020) were related factors of the normalization of PLT. Multivariate logistic regression analysis suggested that HBsAg positive(OR=4.345, P=0.027) influenced the normalization of PLT.Conclusions HARRT is the most effective treatment to the HIV/AIDS patients with thrombocytopenia, and the timely initiation of HAART can avoid the continuous decrease of thrombocyte. HBsAg positive is the main factor to affect the normalization of PLT. Adequate attention should be given to the patients with risk factors, and intervention should be implemented in time.