CAJ | 학술논문

目的：分析182例HIV/AIDS实施高效抗反转录病毒治疗（highly active antiretroviral therapy, HAART）的效果及其影响因素，为进一步有效治疗提供依据。方法采用回顾性调查方法，对我院接受规范HAART的182例HIV/AIDS患者的CD4+T淋巴细胞绝对计数和病毒载量进行分析。结果182例中，157例治疗后CD4+T淋巴细胞计数增加，且在治疗后前6个月内增加速度最快，随着治疗时间延长则较为缓慢。病毒载量在治疗后的6个月内下降最快，大部分降至血浆检测不到的水平，6个月后比较稳定；但随着治疗时间延长，部分患者的病毒载量出现反弹，可能与患者服药依从性差和病毒耐药性的出现有关。治疗前后CD4+T淋巴细胞计数差异有统计学意义（P＜0.05）。多因素logistic回归分析表明年龄和病毒载量是影响HAART疗效的危险因素，基线CD4+T淋巴细胞计数和按时服药是保护因素。结论 HAART能明显增加CD4+T淋巴细胞计数，降低病毒载量，有效控制机会感染，治疗效果显著。影响HAART疗效的因素是多方面的，在治疗过程中应综合考虑各种可能影响因素以提高疗效，对符合条件的患者应尽早进行规范的抗病毒治疗。
목적：분석182례HIV/AIDS실시고효항반전록병독치료（highly active antiretroviral therapy, HAART）적효과급기영향인소，위진일보유효치료제공의거。방법채용회고성조사방법，대아원접수규범HAART적182례HIV/AIDS환자적CD4+T림파세포절대계수화병독재량진행분석。결과182례중，157례치료후CD4+T림파세포계수증가，차재치료후전6개월내증가속도최쾌，수착치료시간연장칙교위완만。병독재량재치료후적6개월내하강최쾌，대부분강지혈장검측불도적수평，6개월후비교은정；단수착치료시간연장，부분환자적병독재량출현반탄，가능여환자복약의종성차화병독내약성적출현유관。치료전후CD4+T림파세포계수차이유통계학의의（P＜0.05）。다인소logistic회귀분석표명년령화병독재량시영향HAART료효적위험인소，기선CD4+T림파세포계수화안시복약시보호인소。결론 HAART능명현증가CD4+T림파세포계수，강저병독재량，유효공제궤회감염，치료효과현저。영향HAART료효적인소시다방면적，재치료과정중응종합고필각충가능영향인소이제고료효，대부합조건적환자응진조진행규범적항병독치료。
Objective To evaluate the therapeutic efficacy of highly active antiretroviral therapy (HAART) and its influencing factors in 182 patients with HIV/AIDS, so as to provide the evidence for effective treatment of HIV/AIDS. Methods All the cases were analyzed retrospectively. CD4+ T lymphocyte counts and viral load of 182 patients with HIV/AIDS receiving HAART in our hospital were detected and analyzed. Results Of 182 patients, 157 showed an increase in CD4+T lymphocyte counts after starting HAART, and the CD4+T lymphocyte counts increased most rapidly in the first 6 months of HAART, while they increased relatively slowly as time of receiving HAART prolonged. In addition, viral load decreased most rapidly in the first 6 months of HAART, with undetectable level in plasma of the most patients, and it kept relatively stable after 6 months of HAART. However, viral load re-bounded in some patients as time of receiving HAART prolonged, probably due to poor medication adherence or occurrence of drug resistance. CD4+T lymphocyte counts were significantly different between pretherapy and post-therapy (P<0.05). Multivariate logistic regression analysis showed that age and viral load were the risk factors affecting the efficacy of HAART, and baseline CD4+T lym-phocyte counts and taking antiviral drugs on time were the protective factors. Conclusions The efficacy of HAART is remarkable in significantly increasing CD4+T lymphocyte counts, reducing viral load, and effectively controlling opportunistic infections. However, there are a variety of factors affecting the efficacy of HAART, so the possible influencing factors should be taken into consideration in the process of treatment, and eligible patients should be given standard HAART as soon as possible.