CAJ | 학술논문

目的了解中国部分HIV/MDS患者在高效抗逆转录病毒治疗(HAART)后HIV相关脂肪营养不良综合征(HIV-LD)的临床特点和危险因素.方法收集2007年3-5月期间在我院门诊随诊的成年HIV/AIDS患者55例,根据患者报告和医师评估结果 ,将上述患者分成HIV-LD组与非脂肪营养不良综合征(HIV-NLD)组.对两组HIV/AIDS患者进行全身双能X射线扫描(DEXA),并比较两组间临床特点、治疗过程及实验室检查指标的差异,分析发生HIV-LD的可能危险因素.结果 55例HIV/AIDS患者中,脂肪异常分布发生率为47.3%.多因素分析结果显示,HAART暴露2年以上、司他夫定(d4T)暴露1年以上与HIV-LD的发生独立相关.DEXA结果显示,HIV/AIDS患者脂肪异常分布主要表现为外周脂肪萎缩.结论脂肪异常分布在接受HAART的AIDS患者中有较高发生率,表现为外周脂肪萎缩.HAART长期治疗及使用d4T方案,尤其后者,是HIV-LD的独立危险因素.
목적 료해중국부분HIV/MDS환자재고효항역전록병독치료(HAART)후HIV상관지방영양불량종합정(HIV-LD)적림상특점화위험인소.방법 수집2007년3-5월기간재아원문진수진적성년HIV/AIDS환자55례,근거환자보고화의사평고결과 ,장상술환자분성HIV-LD조여비지방영양불량종합정(HIV-NLD)조.대량조HIV/AIDS환자진행전신쌍능X사선소묘(DEXA),병비교량조간림상특점、치료과정급실험실검사지표적차이,분석발생HIV-LD적가능위험인소.결과 55례HIV/AIDS환자중,지방이상분포발생솔위47.3%.다인소분석결과 현시,HAART폭로2년이상、사타부정(d4T)폭로1년이상여HIV-LD적발생독립상관.DEXA결과 현시,HIV/AIDS환자지방이상분포주요표현위외주지방위축.결론 지방이상분포재접수HAART적AIDS환자중유교고발생솔,표현위외주지방위축.HAART장기치료급사용d4T방안,우기후자,시HIV-LD적독립위험인소.
Objective To study the prevalence, clinical characteristics and risk factors of HIV-related lipodystrophy syndrome (HIV-LD) in our cohort of HIV-1 infected Chinese adults. Methods In a cross-sectional study, 55 HIV-infected patients were recruited from the HIV clinic of Peking Union Medical College Hospital; most of them were undergoing the first-class highly active antiretroviral therapy (HAART) of today in China. Lipoatrophy or lipohypertrophy was defined if there was concordance between the report of fat change and clinical examination of the participants. Whole body dual-energy X-ray absorptiometry (DEXA) scanning was performed. Results Prevalence of clinical body fat redistribution in the present study was 47.3%. Comparing with non-LD patients, HIV-LD patients had elder age and longer exposure to HAART(P<0.05). HAART exposure and stavudine(d4T) usage were two independent risk factors for HIV-LD. Conclusions HIV-related fat redistribution does exist in Chinese HIV population. Peripheral lipoatrophy occurs commonly in HIV-infected adults but is not associated with increased trunk fat. HAART exposure and especially d4T usage are independent risk factors for HIV-LD.