中华传染病杂志
中華傳染病雜誌
중화전염병잡지
CHINESE JOURNAL OF INFECTIOUS DISEASES
2010年
8期
480-483
,共4页
史宪凤%邹典定%桂希恩%赵东赤
史憲鳳%鄒典定%桂希恩%趙東赤
사헌봉%추전정%계희은%조동적
抗逆转录病毒治疗,高效%儿童%获得性免疫缺陷综合征%逆转录酶抑制剂
抗逆轉錄病毒治療,高效%兒童%穫得性免疫缺陷綜閤徵%逆轉錄酶抑製劑
항역전록병독치료,고효%인동%획득성면역결함종합정%역전록매억제제
Antiretroviral therapy,highly active%Child%Acquired immunodeficiency syndrome%Reverse transcriptase inhibitors
目的 评估抗反转录病毒疗法(ART)治疗儿童AIDS的效果.方法 选择2004年3月至2008年12月符合世界卫生组织规定的治疗条件的22例HIV感染儿童进行ART,治疗方案为2种核苷类反转录酶抑制剂(NRTI)和1种非核苷类反转录酶抑制剂(NNRTI)的联合应用.治疗前、治疗后1～36个月定期检测身高、体质量、血常规、外周血CD4+T淋巴细胞数量、CD8+T淋巴细胞数量和血浆病毒载量(VL),并对两组数据进行t检验.结果 19例获得临床进步,治疗后6个月身高增加倍数为1.04±0.02(t=2.356,P＜0.05),体质量增加倍数为1.14±0.01(t=2.567,P＜0.05),机会性感染率下降(72.7%比27.3%);3例临床治疗失败,其身高、体质量增加迟缓,甚至下降,其中2例死亡.19例获临床进步的儿童中,VL在治疗后3个月均降至2.7 lg拷贝/mL以下;CD4+T淋巴细胞数从(145.50±86.72)×106/L升至治疗后3个月(262.80± 213.62)×106/L(t=2.668,P＜0.05);CD4+/CD8+T淋巴细胞比值为0.14±0.11比0.23±0.21(t=2.607,P＜0.05),其中CD4+/CD8+T淋巴细胞比值在治疗后9个月上升至峰值,而CD4+T淋巴细胞数绝对值在12个月达到峰值,随后至36个月均维持在较高水平;外周血WBC和RBC总数均下降,Hb从(107.29±13.74)g/L升至(112.15±11.20)g/L(t=2.325,P＜0.05).结论 现阶段在我国试点开展的ART治疗方案能够抑制儿童AIDS体内病毒复制,是机体免疫重建和临床症状改善的有效方案.
目的 評估抗反轉錄病毒療法(ART)治療兒童AIDS的效果.方法 選擇2004年3月至2008年12月符閤世界衛生組織規定的治療條件的22例HIV感染兒童進行ART,治療方案為2種覈苷類反轉錄酶抑製劑(NRTI)和1種非覈苷類反轉錄酶抑製劑(NNRTI)的聯閤應用.治療前、治療後1～36箇月定期檢測身高、體質量、血常規、外週血CD4+T淋巴細胞數量、CD8+T淋巴細胞數量和血漿病毒載量(VL),併對兩組數據進行t檢驗.結果 19例穫得臨床進步,治療後6箇月身高增加倍數為1.04±0.02(t=2.356,P＜0.05),體質量增加倍數為1.14±0.01(t=2.567,P＜0.05),機會性感染率下降(72.7%比27.3%);3例臨床治療失敗,其身高、體質量增加遲緩,甚至下降,其中2例死亡.19例穫臨床進步的兒童中,VL在治療後3箇月均降至2.7 lg拷貝/mL以下;CD4+T淋巴細胞數從(145.50±86.72)×106/L升至治療後3箇月(262.80± 213.62)×106/L(t=2.668,P＜0.05);CD4+/CD8+T淋巴細胞比值為0.14±0.11比0.23±0.21(t=2.607,P＜0.05),其中CD4+/CD8+T淋巴細胞比值在治療後9箇月上升至峰值,而CD4+T淋巴細胞數絕對值在12箇月達到峰值,隨後至36箇月均維持在較高水平;外週血WBC和RBC總數均下降,Hb從(107.29±13.74)g/L升至(112.15±11.20)g/L(t=2.325,P＜0.05).結論 現階段在我國試點開展的ART治療方案能夠抑製兒童AIDS體內病毒複製,是機體免疫重建和臨床癥狀改善的有效方案.
목적 평고항반전록병독요법(ART)치료인동AIDS적효과.방법 선택2004년3월지2008년12월부합세계위생조직규정적치료조건적22례HIV감염인동진행ART,치료방안위2충핵감류반전록매억제제(NRTI)화1충비핵감류반전록매억제제(NNRTI)적연합응용.치료전、치료후1～36개월정기검측신고、체질량、혈상규、외주혈CD4+T림파세포수량、CD8+T림파세포수량화혈장병독재량(VL),병대량조수거진행t검험.결과 19례획득림상진보,치료후6개월신고증가배수위1.04±0.02(t=2.356,P＜0.05),체질량증가배수위1.14±0.01(t=2.567,P＜0.05),궤회성감염솔하강(72.7%비27.3%);3례림상치료실패,기신고、체질량증가지완,심지하강,기중2례사망.19례획림상진보적인동중,VL재치료후3개월균강지2.7 lg고패/mL이하;CD4+T림파세포수종(145.50±86.72)×106/L승지치료후3개월(262.80± 213.62)×106/L(t=2.668,P＜0.05);CD4+/CD8+T림파세포비치위0.14±0.11비0.23±0.21(t=2.607,P＜0.05),기중CD4+/CD8+T림파세포비치재치료후9개월상승지봉치,이CD4+T림파세포수절대치재12개월체도봉치,수후지36개월균유지재교고수평;외주혈WBC화RBC총수균하강,Hb종(107.29±13.74)g/L승지(112.15±11.20)g/L(t=2.325,P＜0.05).결론 현계단재아국시점개전적ART치료방안능구억제인동AIDS체내병독복제,시궤체면역중건화림상증상개선적유효방안.
Objective To evaluate the therapeutic effects of antiretroviral therapy(ART)on human immunedeficiency virus (HIV)-1-infected children. Methods Twenty-two HIV-1-infected children who met World Health Organization (WHO) criteria for treatment received ART and were prospectively enrolled in this study. ART contained two kinds of nucleoside reverse transcriptase inhibitor (NRTI) combined with one kind of non-nucleoside reverse transcriptase inhibitor (NNRTI).Before ART and 1-36 months after ART, height, body weight, blood routine, peripheral CD4+ and CD8+ T cell counts and plasma viral load were followed up regularly. Comparison between groups was done by test. Results Among the 22 pediatric AIDS patients, 19 cases (86.4%) achieved clinical improve, whose height and body weight increased significantly 6 months after ART (height = 1 :1.04±0. 02, t=2. 356, P<0. 05; body weight= 1: 1. 14±0. 01,t=2. 567,P< 0. 05) and opportunistic infection rate decreased (72.7 % vs. 27.3 %) ; 3 patients (13.6 % ) deteriorated, whose height and body weight increased slowly and even decreased, 2 of them died. In the 19 improved patients, viral load declined to <2.7 lg copy/mL at month 3 of ART, CD4+ T cell counts and CD4+/CD8+ ratio significantly increased at month 3 of ART (CD4+ T cell counts: 145.50±86.72 vs. 262.80±213.62,t=2. 668, P<0.05; CD4+/CD8+ ratio: 0. 14±0. 11 vs. 0.23±0. 21,t=2. 607, P<0. 05) and CD4+/CD8+ ratio peaked at month 9 and absolute number of CD4+ T cell counts peaked at month 12 and maintained at high level until month 36, peripheral white blood cells (WBC) and red blood cells (RBC) both decreased, while hemoglobin (Hb) contents increased significantly (107.29 ± 13.74 vs. 112. 15±11.20,t=2. 325,P<0. 05). Conclusion ART is an effective strategy for inhibition of HIV-1 replication,reconstruction of immune responses and improvement of clinical symptoms in AIDS children.
