中国HIV-1感染人群神经认知损害初步筛查  

An initial screening for HIV-1 associated neurocognitive disorders in HIV-1 infected patients in China

作　　者：宋凤丽[1] 张玉林[2] 乔录新[1] 丁渭[1] 徐树莹[1] 张彤[2] 吴昊[2] 陈德喜[1] 

机构地区：[1]北京市肝病研究所,首都医科大学附属北京佑安医院,北京100069 [2]首都医科大学附属北京佑安医院感染科,北京100069

出　　处：《首都医科大学学报》2012年第5期610-615,共6页Journal of Capital Medical University

基　　金：国家自然科学基金(30910103915);国家“十二五”重大科技专项(2012ZX10001-003,2012ZX10001-004);北京市自然科学基金(7101005,7092045)~~

摘　　要：目的初步调查中国人类免疫缺陷病毒-1(human immunodeficiency virus 1,HIV-1)感染者神经认知损害情况。方法通过国际HIV痴呆量表和神经心理评估,结合症状评分和临床相关资料对我国HIV-1感染人群HIV相关神经认知障碍(HIV-1associated neurocognitive disorders,HAND)患病情况进行初步调查。结果①我国HIV-1感染人群HAND患病率为37%;②认知障碍是主要症状,其次是行为异常;③脑脊液(cerebrospinal fluid,CSF)病毒载量与外周血病毒载量密切相关,但与HAND无关,同样HAND与CD4计数也无关。结论结果显示中国HIV-1感染人群HAND患病率约为37%,以认知障碍症状为主;CSF与外周血病毒载量呈一致性变化,但是CD4计数和病毒载量不能作为诊断和预测HAND病情的指标,上述结果需要进一步的大样本调查予以证实。Objective To initially screen for the HIV-1 associated neurocognitive disorders （HAND） in HIV-1 infected patients in China. Methods The International HIV Dementia Scale and a neuropsychological test battery were administered for screening and diagnosis of HAND in 134 HIV-1 infected patients in China. Subjective complaints, CD4 count and viral loads in both blood plasma and cerebrospinal fluid（CSF） were correlated with diagnosis of HAND. Results The prevalence of HAND in Chinese HIV-1 infected patients was 37%. The presence of HAND was associated with cognitive and behavior disorder complaints （4.9 and 4.1 fold higher than those without HAND, respectively）. The level of viral load in CSF correlated with that in blood, but neither viral load （both in CSF and in blood） nor CD4 counts was found significantly different between HAND and non-HAND patients. Conclusion The prevalence of HAND in Chinese HIV-1 infected patients was 37%. Cognitive impairment is major complaint in HAND patients, followed by behavior disorder. None of viral load （viral load in CSF or in blood） and CD4 counts could predict the occurrence and development of HAND. Larger sample size, longitudinal observation and additional laboratory characterizations are needed to better characterize neurocognitive function among HIV-infected oeople in China.

关 键 词：人类免疫缺陷病毒相关神经认知障碍 患病率 临床表现 中国人群 

分 类 号：R512.91[医药卫生—内科学]