中华内科杂志
中華內科雜誌
중화내과잡지
CHINESE JOURNAL OF INTERNAL MEDICINE
2010年
8期
649-652
,共4页
郭伏平%于晓波%罗玲%韩扬%邱志峰%左玲燕%李雁凌%余卫%李太生
郭伏平%于曉波%囉玲%韓颺%邱誌峰%左玲燕%李雁凌%餘衛%李太生
곽복평%우효파%라령%한양%구지봉%좌령연%리안릉%여위%리태생
获得性免疫缺陷综合征%骨密度%高效抗逆转录病毒治疗
穫得性免疫缺陷綜閤徵%骨密度%高效抗逆轉錄病毒治療
획득성면역결함종합정%골밀도%고효항역전록병독치료
Acquired immunodeficiency syndrome%Bone density%Highly active antiretroviral therapy
目的 评价高效抗逆转录病毒治疗(HAART)对HIV感染患者骨密度(BMD)的影响及其相关因素.方法 收集2007-2008年间50例接受HAART的HIV/MDS患者(治疗组)、12例未用HAART的HIV/AIDS患者(未治疗组)、20例健康对照者(对照组)的临床资料,采用双能X线BMD吸收仪(DEXA)测定BMD以及T值,分别对其数据进行统计分析.结果 治疗组中19例(38.0%)患者发生骨量减少,1例(2.0%)患者发生骨质疏松.对照组中5例(25.0%)发生骨量减少,无骨质疏松者.未治疗组中6例(50.0%)患者发生骨量减少,2例(16.7%)患者发生骨质疏松.未治疗组骨量减少/骨质疏松发生率较对照组显著增高(P=0.02).HIV/AIDS组(包括未治疗组和治疗组)的股骨、股骨颈、大粗隆的BMD[(0.97±0.14)、(0.91±0.13)、(0.76 4-0.12)g/cm2]明显低于对照组[(1.04±0.12)、(0.98±0.14)、(0.84±0.11)g/cm2,P<0.05];而未治疗组和治疗组的BMD差异无统计学意义.治疗组中,骨量减少/骨质疏松与体重<60 kg(r=0.074,P=0.004)、使用HAART前血浆病毒载量(r=5.103,P=0.021)呈正相关.结论 未接受HAART的HIV/AIDS患者较健康人骨量减少/骨质疏松发生率高.HIV/MDS患者BMD较健康人低,接受HAART和未接受HAART治疗的HIV/AIDS患者BMD相当.接受HAART患者中,体重<60 kg、治疗前HIV RNA是发生骨量减少/骨质疏松的危险因素.
目的 評價高效抗逆轉錄病毒治療(HAART)對HIV感染患者骨密度(BMD)的影響及其相關因素.方法 收集2007-2008年間50例接受HAART的HIV/MDS患者(治療組)、12例未用HAART的HIV/AIDS患者(未治療組)、20例健康對照者(對照組)的臨床資料,採用雙能X線BMD吸收儀(DEXA)測定BMD以及T值,分彆對其數據進行統計分析.結果 治療組中19例(38.0%)患者髮生骨量減少,1例(2.0%)患者髮生骨質疏鬆.對照組中5例(25.0%)髮生骨量減少,無骨質疏鬆者.未治療組中6例(50.0%)患者髮生骨量減少,2例(16.7%)患者髮生骨質疏鬆.未治療組骨量減少/骨質疏鬆髮生率較對照組顯著增高(P=0.02).HIV/AIDS組(包括未治療組和治療組)的股骨、股骨頸、大粗隆的BMD[(0.97±0.14)、(0.91±0.13)、(0.76 4-0.12)g/cm2]明顯低于對照組[(1.04±0.12)、(0.98±0.14)、(0.84±0.11)g/cm2,P<0.05];而未治療組和治療組的BMD差異無統計學意義.治療組中,骨量減少/骨質疏鬆與體重<60 kg(r=0.074,P=0.004)、使用HAART前血漿病毒載量(r=5.103,P=0.021)呈正相關.結論 未接受HAART的HIV/AIDS患者較健康人骨量減少/骨質疏鬆髮生率高.HIV/MDS患者BMD較健康人低,接受HAART和未接受HAART治療的HIV/AIDS患者BMD相噹.接受HAART患者中,體重<60 kg、治療前HIV RNA是髮生骨量減少/骨質疏鬆的危險因素.
목적 평개고효항역전록병독치료(HAART)대HIV감염환자골밀도(BMD)적영향급기상관인소.방법 수집2007-2008년간50례접수HAART적HIV/MDS환자(치료조)、12례미용HAART적HIV/AIDS환자(미치료조)、20례건강대조자(대조조)적림상자료,채용쌍능X선BMD흡수의(DEXA)측정BMD이급T치,분별대기수거진행통계분석.결과 치료조중19례(38.0%)환자발생골량감소,1례(2.0%)환자발생골질소송.대조조중5례(25.0%)발생골량감소,무골질소송자.미치료조중6례(50.0%)환자발생골량감소,2례(16.7%)환자발생골질소송.미치료조골량감소/골질소송발생솔교대조조현저증고(P=0.02).HIV/AIDS조(포괄미치료조화치료조)적고골、고골경、대조륭적BMD[(0.97±0.14)、(0.91±0.13)、(0.76 4-0.12)g/cm2]명현저우대조조[(1.04±0.12)、(0.98±0.14)、(0.84±0.11)g/cm2,P<0.05];이미치료조화치료조적BMD차이무통계학의의.치료조중,골량감소/골질소송여체중<60 kg(r=0.074,P=0.004)、사용HAART전혈장병독재량(r=5.103,P=0.021)정정상관.결론 미접수HAART적HIV/AIDS환자교건강인골량감소/골질소송발생솔고.HIV/MDS환자BMD교건강인저,접수HAART화미접수HAART치료적HIV/AIDS환자BMD상당.접수HAART환자중,체중<60 kg、치료전HIV RNA시발생골량감소/골질소송적위험인소.
Objective To evaluate the influence of highly active antiretroviral therapy ( HAART) on bone mineral density ( BMD ) of human immunodeficiency virus ( HIV) infected patients and correlating clinical factors. Methods The clinical data from 2007 to 2008 were analyzed, including 50 patients treated with HAART (named treated group) ,12 HIV-infected antiretroviral-naive patients (named untreated group) and 20 healthy people (named control group).Lumbar, femoral neck, femur, femoral greater trochanter and whole body BMD were measured by dual energy X-ray absorptiometry.The data were respectively analyzed.Results There were 19 (38.0% ) patients with osteopenia and 1(2.0% ) patient with osteoporosis in the treated group.There were 6(50.0% ) patients with osteopenia and 2 (16.7% ) patient with osteoporosis in the untreated group.There were 5(25.0% ) patients with osteopenia, no one with osteoporosis in the control group.The prevalence of osteopenia/osteoporosis was statistically higher in the untreated group than that in the control group (P = 0.02).The BMD of femur, femoral neck and greater trochanter [(0.97±0.14) , (0.91 ±0.13 ) , (0.76 ±0.12) g/cm2] in the HIV-infected group (including the treated and untreated group) were significantly lower than that in the control group [(1.04±.12) , (0.98±.14) , (0.84±0.11) g/cm2 ,P <0.05].There were no significantly differences in the BMD between the untreated group and the treated group.In the treated group, osteopenia/osteoporosis correlated with body weight less than 60 kg (r=0.074,P =0.004) and the viral load before HAART(r=5.103,P =0.021).Conclusions The prevalence of osteopenia and osteoporosis in antiretroviral-naive HIV-infected patients is higher.The BMD of HIV-infected patients are reduced compared with the healthy people.The BMD is similar among HIVinfected patients irrespective of antiretroviral treatment Body weight less than 60 kg and the viral load before HAART are the risk factors of osteopenia/osteoporosis for the HIV-infected antiretroviral patients.
