61例慢性肾脏病维持透析的HIV/AIDS患者血钙、血磷、全段甲状旁腺激素水平调查研究

摘要

ObjectiveTo investigate the mineral metabolism disorder and possible influencing factors in HIV/AIDS patients with maintenance hemodialysis (MHD) in Guangxi area.MethodsSixty-one HIV/AIDS patients treated with MHD for more than 3 months in the Fourth People's Hospital of Nanning (Guangxi AIDS Clinical Treatment Center) from 2011 to 2016 were enrolled in this study, and as the observation group, divided into 2 groups: highly active antiretroviral therapy (HAART) group (n=51) and non-HAART group (n=10 cases). In addition, 30 non-HIV/AIDS patients treated with MHD for more than 3 months were selected as control group. The mineral metabolism indexes including blood calcium, phosphorus and intact varathvroid hormone (iPTH) were determined. Then the related influencing factors were explored.Results Among the 61 HIV/AIDS patients, the control rate of blood calcium, serum phosphorus and iPTH was 47.54% (29/61), 24.59% (15/61) and 21.31% (13/61), respectively. Compared with the control group, the level of blood calcium, phosphorus, iPTH, haemoglobin and ALB levels in the HIV group were significantly lower (P<0.05). However, the levels of serum calcium and iPTH in the HAART group were higher than that in non-HAART group. Serum phosphorus in the HAART group were lower than that in non-HAART group (P<0.05).ConclusionsHIV/AIDS patients in Guangxi area undergoing MHD treatment exhibit unique clinical manifestations of abnormal mineral metabolism. The way of hemodialysis, HAART treatment program and its impact factor need further study.%目的了解广西地区维持性血液透析HIV/AIDS患者矿物质代谢紊乱情况及可能相关影响因素.方法收集2011—2016年在南宁市第四人民医院维持性血液透析3个月及以上合并HIV感染的61例患者作为观察组,根据其治疗情况,分为高效抗反转录病毒治疗(highly active antiretroviral therapy,HAART)组(51例)及非HAART组(10例),另选取30例非HIV感染维持血液透析大于3个月患者作为对照组.检测患者血钙、血磷及全段甲状旁腺激素(inact parathyroid hormone,iPTH)等矿物质代谢的评估指标,并对相关影响因素进行探讨.结果观察组中,血钙、血磷、iPTH的达标率分别为47.54%(29/61),24.59%(15/61)和21.31%(13/61);与对照组相比,在血钙、血磷、iPTH、HGB及ALB的平均值方面差异均有统计学意义(P均<0.05);在观察组中,HAART患者血钙、iPTH指标均高于非HAART患者,血磷指标低于非HAART患者(P均<0.05).结论广西地区维持性血液透析HIV/AIDS患者矿物质代谢异常有其独特的临床表现,对于该人群的透析方式、HAART方案、影响因素值得进一步研究.