奈韦拉平抗病毒治疗药物不良反应与CD4+淋巴细胞计数的关系  

Correlation Between the Adverse Effects Associated with the Use of Nevirapine and CD4+ Lymphocyte Count

作　　者：范文穗 李巍[1] 刘艳[1] 邓协 简炎林[1] 

机构地区：[1]深圳市第三人民医院,广东深圳518112

出　　处：《中外医疗》2014年第10期34-35,共2页China & Foreign Medical Treatment

摘　　要：目的分析服用奈韦拉平(NVP)组抗逆转录病毒治疗艾滋病患者中,使用奈韦拉平初治发生皮疹和肝损害的情况统计及相应处理对策。方法将170例艾滋病患者按CD4+T淋巴细胞计数水平的多少分为两组。A组CD4+细胞计数<200个/μL的患者,B组CD4+细胞计数≥200个/μL的患者,两组初治患者使用以下方案:齐多夫定+拉米夫定+奈韦拉平或替诺福韦+拉米夫定+奈韦拉平或司他夫定+拉米夫定+奈韦拉平。分别与治疗前治疗后半个月,1个月,2个月,3个月,监测肝功能,血常规,CD4+T淋巴计数,监测有无皮疹变化。分析两组3个月内的肝功能变化观察皮疹情况。分析皮疹及肝损害发生与CD4+细胞计数的关系。结果 A组皮疹发生率为24.7%,B组皮疹发生率为54.1%,差异均有统计学意义(P<0.001);A组肝损害发生率为12.9%,B组肝损害发生率为25.9%,差异均有统计学意义(P<0.05)。结论服用奈韦拉平皮疹和肝损害的发生率与CD4+细胞计数有关。Objective To analyze the incidences of adverse effects associated with rash and liver damage in AIDS patients receiv-ing nevirapine-containing antiretroviral therapy and the corresponding countermeasures. Methods A total of 170 AIDS patients were divided into two groups by the CD4＋ T cell count. In group A patients, CD4＋cell count 〈200 cells/μl; and in group B pa-tients, CD4＋cell count ≧200 cells/μl. Both of the groups＇ patients used the scheme below：zidovudine ＋ lamivudine ＋ nevirapine/tenofovir ＋ lamivudine ＋ nevirapine /stavudine ＋ lamivudine ＋ nevirapine. The correlation between adverse reactions and CD4＋cell count was analyzed by comparing the results of liver function, routine blood test, CD4＋ T cell count and skin rash before and after half month, one month and three-month treatment. Results The incidence of rash is 24.7% in group A and 54.1% in group B, respectively, the difference is statistically significant （P〈0.001）. The incidence of liver damage is 12.9%in group A and 25.9%in group B, respectively, the difference is statistically significant （P〈0.05）. Conclusion The incidences of rash and liver damage correlate with CD4＋cell count in AIDS patients receiving nevirapine therapy.

关 键 词：艾滋病 奈韦拉平 肝损害 抗逆转录病毒治疗 

分 类 号：R978.7[医药卫生—药品]