高效抗反转录病毒治疗对HIV-1感染者抑郁情绪的影响及其评估  

Assessment on depressive status and the therapeutic effects of highly active antiretroviral therapy among anti-HIV-1 （ ＋） population

作　　者：张俐[1] 杨涤[1] 赵红心[1] 韩宁[1] 肖江[1] 陈玉芳[2] 韩筑[2] 李彦媚[3] 魏凯[1] 张雯[4] 郜桂菊[1] 

机构地区：[1]首都医科大学附属北京地坛医院感染中心,北京100015 [2]北京大学精神卫生研究所 [3]北京大学医学部 [4]首都医科大学

出　　处：《中华流行病学杂志》2013年第5期461-463,共3页Chinese Journal of Epidemiology

基　　金：美国NIH项目（1R01MH092225-01）;北京市朝阳区艾滋病和病毒性肝炎等重大传染病综合防治示范区建设研究（2012ZX10004-904）

摘　　要：目的评估HIV-1感染者抑郁状态及影响因素，探讨高效抗反转录病毒治疗（HAART）及CD4＋T淋巴细胞计数水平对其影响。方法以2011年3月至2012年6月北京地坛医院年龄18～65岁抗HIV-1阳性且达到开始抗HIV治疗标准，但尚未治疗的门诊患者为研究对象。调查采用抑郁自评量表贝克抑郁量表第二版（BDI—II）及自行设计的问卷，对受试者基线及HAART48周后进行测评。统计采用t检验及Wilcoxon秩和检验比较不同条件及HAART前后的BDI分值。结果（1）基线100例抗HIV-1（＋）患者，男女比例99：1，平均年龄（31．37±5．58）岁，平均接受教育（13．13±3．51）年，无业人员占4％，发现抗HIV-1阳性中位时间为5．0（1．0～21．0）个月，83％为同性性传播。基线BDI中位数为6．0（3—10．25）分。（2）受教育时间≤12年的患者与〉12年的患者其BDl分值的差异无统计学意义（P〉0．05）；发现抗HIV-1阳性时间≤6个月的患者BDl分值高于〉6个月的患者，差异有统计学意义（P〈0．05）；基线CD4＋T淋巴细胞计数≤200cell／μl患者的BDl分值高于〉200cell／μl患者，且差异有统计学意义（P〈0．05）。抗病毒治疗48周前后CD4＋T淋巴细胞计数水平明显升高（P〈0．001），而BDl分值的差异并无统计学意义（P〉0．05）；不同抑郁程度的患者在抗病毒治疗48周前后其BDl分值变化无统计学意义（P〉0．05）。结论HIV感染者的抑郁情绪在得知感染的最初6个月较为明显，其抑郁程度在基线CD4＋T淋巴细胞计数〈200cell／μl者中更为严重。单纯HAART可提高免疫水平，但并不能改善其抑郁状态。Objective To assess the depressive status and its influence on Chinese HIV-1 （ ＋ ） population, and how it was influenced by highly active antiretroviral therapy （HAART） and the CD4＋ T cell count. Methods Anti-HIV-1 （ ＋ ） patients （age between 18 and 65 years old） who had met the criteria to commence the anti-HIV treatment but had not yet started, were selected from the Beijing Ditan Hospital between March 2011 and June 2012. BDI- II （Beck Depression Inventory） and a self-designed questionnaire were used to evaluate the baseline and the status of 48 weeks post the HAART treatment. Statistically, t test and the Wilcoxon rank sum test were used to compare the BDI scores under different conditions and before/after the HAART. Results （ 1 ） Of 100 subjects： male to female ratio was 99 ： 1; the average age was 31.37 ＋ 5.58 years; the average education background was of 13.13 ＋ 3.51 years; the unemployed percentage was 4% ; time before being identified as anti-HIV-1 （ ＋ ） was 5.0 （1.0-21.0）months; the percentage being infected through homosexual contact was 83%. The baseline BDI score was 6.0（3-10.25）. （2） There was no significant difference （P〈0.05） in BDI score between those subjects having had education less or more than 12 years; the BDI score of patients whose anti-HIV-1 （ ＋ ） was significantly higher （P〈0.05） among those discovered within the past 6 months than those more than 6 months. The BDI score of patients whose baseline CD4＋T cell count below 200 cells/pl was significantly higher （P〈0.05） than those with baseline CD4＋ T cell count greater than 200 cells/μl. The CD4＋ T cell count was significantly high （P〈 0.001 ） after 48 weeks of anti-viral treatment, but the BDI score was not significantly different （P〉 0.05）. There was no significant change （P〉0.05） in the proportion of patients with different degrees of BDI score before and after 48 weeks of antiviral treatment. Conclusion Depression in HIV patients w

关 键 词：艾滋病病毒感染 抑郁 高效抗反转录病毒治疗 

分 类 号：R51[医药卫生—内科学] R74[医药卫生—临床医学]