中华医学杂志
中華醫學雜誌
중화의학잡지
National Medical Journal of China
2012年
17期
1155-1158
,共4页
苏元波%谢静%韩扬%邱志峰%李雁凌%宋晓璟%余卫%李太生
囌元波%謝靜%韓颺%邱誌峰%李雁凌%宋曉璟%餘衛%李太生
소원파%사정%한양%구지봉%리안릉%송효경%여위%리태생
抗逆转录病毒治疗,高效%骨密度%HIV
抗逆轉錄病毒治療,高效%骨密度%HIV
항역전록병독치료,고효%골밀도%HIV
Antiretroviral therapy,highly active%Bone density%HIV
目的 评价长期高效抗逆转录病毒治疗(HAART)对HIV/AIDS患者骨密度(BMD)的影响及相关因素.方法 招募2001-2011年北京协和医院收治的149例HIV感染患者,其中未治疗组41例,治疗1～2年组60例,治疗＞5年组48例,以20名健康志愿者为对照组.经双能X线骨密度吸收仪(DXA)测量全身、腰椎1～4、右髋部和右股骨颈BMD-Z值及T值.结果 治疗＞5年组右髋部BMD-Z值(0.16±0.82)显著低于未治疗组(0.61±1.09)(P =0.039).治疗＞5年组右股骨颈BMD-Z值(-0.002±0.87)显著低于未治疗组(0.55±1.08) (P =0.012).治疗1～2年组BMD-Z值与治疗＞5年组、未治疗组及健康对照组差异无统计学意义.治疗1～2年组及治疗＞5年组骨量减少/骨质疏松发生率显著高于未治疗组.右髋部及右股骨颈BMD-Z值与HAART时间呈负相关.体重是影响骨量减少/骨质疏松发生的重要危险因素.结论 治疗＞5年组患者髋部及股骨颈BMD显著下降；接受HAART治疗后骨量减少/骨质疏松发生率显著增加.BMD变化与HAART时间呈负相关.长期接受HAART患者合并高龄、体重减低等危险因素需定期复查DXA.
目的 評價長期高效抗逆轉錄病毒治療(HAART)對HIV/AIDS患者骨密度(BMD)的影響及相關因素.方法 招募2001-2011年北京協和醫院收治的149例HIV感染患者,其中未治療組41例,治療1～2年組60例,治療＞5年組48例,以20名健康誌願者為對照組.經雙能X線骨密度吸收儀(DXA)測量全身、腰椎1～4、右髖部和右股骨頸BMD-Z值及T值.結果 治療＞5年組右髖部BMD-Z值(0.16±0.82)顯著低于未治療組(0.61±1.09)(P =0.039).治療＞5年組右股骨頸BMD-Z值(-0.002±0.87)顯著低于未治療組(0.55±1.08) (P =0.012).治療1～2年組BMD-Z值與治療＞5年組、未治療組及健康對照組差異無統計學意義.治療1～2年組及治療＞5年組骨量減少/骨質疏鬆髮生率顯著高于未治療組.右髖部及右股骨頸BMD-Z值與HAART時間呈負相關.體重是影響骨量減少/骨質疏鬆髮生的重要危險因素.結論 治療＞5年組患者髖部及股骨頸BMD顯著下降；接受HAART治療後骨量減少/骨質疏鬆髮生率顯著增加.BMD變化與HAART時間呈負相關.長期接受HAART患者閤併高齡、體重減低等危險因素需定期複查DXA.
목적 평개장기고효항역전록병독치료(HAART)대HIV/AIDS환자골밀도(BMD)적영향급상관인소.방법 초모2001-2011년북경협화의원수치적149례HIV감염환자,기중미치료조41례,치료1～2년조60례,치료＞5년조48례,이20명건강지원자위대조조.경쌍능X선골밀도흡수의(DXA)측량전신、요추1～4、우관부화우고골경BMD-Z치급T치.결과 치료＞5년조우관부BMD-Z치(0.16±0.82)현저저우미치료조(0.61±1.09)(P =0.039).치료＞5년조우고골경BMD-Z치(-0.002±0.87)현저저우미치료조(0.55±1.08) (P =0.012).치료1～2년조BMD-Z치여치료＞5년조、미치료조급건강대조조차이무통계학의의.치료1～2년조급치료＞5년조골량감소/골질소송발생솔현저고우미치료조.우관부급우고골경BMD-Z치여HAART시간정부상관.체중시영향골량감소/골질소송발생적중요위험인소.결론 치료＞5년조환자관부급고골경BMD현저하강；접수HAART치료후골량감소/골질소송발생솔현저증가.BMD변화여HAART시간정부상관.장기접수HAART환자합병고령、체중감저등위험인소수정기복사DXA.
Objective To evaluate the influence of highly active antiretroviral therapy (HAART) on bone mineral density (BMD) in HIV/AIDS patients and correlating clinical factors.Methods 149 HIV patients were divided into 3 groups:untreated group with 41 patients,HAART for 1 -2 years group with 60 patients,HAART over 5 years group with 48 patients; 20 healthy individuals included as a control group.BMD-T score and BMD-Z score were measured by dual-energy X-ray absorptiometry (DXA).Results BMD-Z score of right hip was significantly lower in HAART over 5 years group (0.16 ± 0.82) than untreated group (0.61 ± 1.09 ) ( P =0.039).BMD-Z score of right femoral neck was significantly lower in HAART over 5 years group ( -0.002 ±0.87) than untreated group(0.55 ± 1.08) ( P =0.012).BMD-Z score of HAART for 1 -2 years group was not significantly decreased.BMD-Z score of right hip and right femoral neck were correlated negatively with HAART duration.The incidence of osteopenia/osteoprosis in HAART for 1 -2 years group (31.7％) and HAART over 5 years group (31.3％) were significantly higher than untreated group ( 12.2％ ) ( P ＜ 0.05 ).Body weight was revealed as a risk factor of osteopenia/osteoporosis.Conclusion BMD of right hip and right femur neck were significantly lower in HAART over 5 years group.The incidence of osteopenia/osteoprosis were significantly higher in patients receiving HAART.BMD were correlated negatively with HAART duration.Patients in long-term HAART combined with risk factors such as old age or lower body weight should be checked by DXA regularly.
