CAJ | 학술논문

目的通过回顾性研究,描述免疫重建不良HIV/AIDS患者的基本特征,探讨免疫重建不良的相关因素,发现HIV/AIDS患者免疫重建不良的预示指标.方法以2005年1月-2011年8月在北京地坛医院起始HAART治疗≥96w的HIV/AIDS患者(503例)为研究对象,比较其中免疫无应答者(76例)与免疫应答良好者(427例)临床资料(人口学资料、基线CD4+T细胞计数、机会性感染的合并情况、HAART(高效抗逆转录病毒治疗)方案和各种化验指标的差异,分析HIV/AIDS患者免疫重建不良的相关因素.结果入组病例中免疫重建不良的发生率为15.11％;免疫重建不良组的基线CD4+T细胞数、总淋巴细胞数目(TLC)及血红蛋白(Hb)显著低于免疫重建良好组(z=-9.056,P＜0.001;z=-5.541,P＜0.001;z=-3.014,P=0.003).免疫重建不良组基线机会性感染合并率显著高于重建良好组(x2=14.834,P=0.037).结论低基线CD4+T细胞数目、TLC及Hb均为免疫重建不良的相关因素,应对HIV感染的患者及早进行治疗,预防免疫重建不良的发生.
목적 통과회고성연구,묘술면역중건불량HIV/AIDS환자적기본특정,탐토면역중건불량적상관인소,발현HIV/AIDS환자면역중건불량적예시지표.방법 이2005년1월-2011년8월재북경지단의원기시HAART치료≥96w적HIV/AIDS환자(503례)위연구대상,비교기중면역무응답자(76례)여면역응답량호자(427례)림상자료(인구학자료、기선CD4+T세포계수、궤회성감염적합병정황、HAART(고효항역전록병독치료)방안화각충화험지표적차이,분석HIV/AIDS환자면역중건불량적상관인소.결과 입조병례중면역중건불량적발생솔위15.11％;면역중건불량조적기선CD4+T세포수、총림파세포수목(TLC)급혈홍단백(Hb)현저저우면역중건량호조(z=-9.056,P＜0.001;z=-5.541,P＜0.001;z=-3.014,P=0.003).면역중건불량조기선궤회성감염합병솔현저고우중건량호조(x2=14.834,P=0.037).결론 저기선CD4+T세포수목、TLC급Hb균위면역중건불량적상관인소,응대HIV감염적환자급조진행치료,예방면역중건불량적발생.
Objective To explore the characters and relative factors of poor immune reconstruction in HIV/AIDS patients,and find the indicators of poor immune reconstruction through retrospective study.Methods Clinical data of 503 HIV/AIDS patients in Beijing Ditan hospital who have received antiretroviral therapy for more than 96 weeks have been collected and studied.The differences of clinical data (demographic data,the baseline CD4 +T counts,opportunistic infection,HARRT regimen,laboratory tests results and so on) between 76 immune non-responders and 427 immune responders have been analyzed and the relative factors of poor immune reconstruction in HIV/AIDS patients have been carried out.Results The incidence rate of the poor immune reconstitution was 15.11％ ; The baseline CD4 + T counts,total lymphocyte count (TLC) and hemoglobin (Hb) were found to be significantly lower in immune non-responders than immune responders(z =-9.056,P ＜ 0.001 ; z =-5.541,P ＜ 0.001 ; z =-3.014,P =0.003).The incidence rate of baseline opportunistic infections in immune non-responders was significantly higher than immune responders (x2 =14.834,P =0.037).Conclusions The relative factors of poor immune reconstitution include low baseline CD4 + T counts,TLC and Hb.early treatment should be provide for HIV/AIDS patients to prevent the occurrence of poor immune reconstitution.