高效抗反转录病毒疗法对艾滋病患者血脂的影响

摘要

目的 研究艾滋病(AIDS)患者高效抗反转录病毒治疗(HAART)后对血脂水平的影响.方法 回顾性调查2005年6月～2011年5月在我科门诊应用高效抗反转录病毒治疗的HIV/AIDS患者100例,平均抗病毒治疗时间(40.78±20.09)个月,HAART方案分别为AZT+ 3TC+ NVP、AZT+ 3TC+ EFV、D4T+ 3TC+ NVP和D4T+ 3TC+ EFV4种,其中D4T+ 3TC+ NVP方案组中体重＞60 kg者,D4T的剂量为每次40 mg,每日2次；体重＜60 kg者,D4T的剂量为每次30 mg,每日2次.对4组患者治疗前后CD4淋巴细胞计数、空腹血脂(包括总胆固醇、三酰甘油、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇)进行比较.结果 HAART后,CD4淋巴细胞计数均升高,总胆固醇、三酰甘油上升,高密度脂蛋白、低密度脂蛋白正常,AZT方案组与D4T方案组比较差异有统计学意义(P＜0.05)；其中D4T +3TC+ NVP方案组中,体重＞60kg、D4T的剂量为每次40 mg与体重＜60 kg、D4T的剂量为每次30 mg比较差异有统计学意义(P＜0.05)；静脉吸毒与性传播所致艾滋病感染,对血脂无明显影响.结论 HAART治疗对5组患者均有效,以D4T为主的HAART治疗方案可引起血脂代谢异常.%Objective To study the effect of highly active antiretroviral therapy on serum lipids in AIDS patients. MethodslOO outpatients with HAART were collected in infectious department from Jun 2005 to May 2011. The mean time of treatment was (40. 78 ± 20. 09 ) months. 100 cases were divided into four groups as follows:AZT + 3TC + NVP,AZT + 3TC + EFV . D4T + 3TC + NVP.D4T + 3TC + EKV. In D4T +3TC + NVP group:40 mg twice of IMT is for weight >60 kg;30 mg twice of D4T is for weight <60 kg. The changes of CD4 counts and serum lipids( TC ,TG ,HDL-C ,LDL-C) before and after the treatment were analyzed retrospectively. Results After HAART,CD4 counts,TC and TG levels increased significantly. The level of HDL-C and LDL-C was normal. There are statistical significance among AZT groups and D4T groups(P<0.05) .between D4T group(80 mg/d) and IMT group(60 mg/d) ,P<0.05. Conclusions HAART is effective in five groups and D4T group can cause dyslipidemia.