HIV/AIDS患者HAART后颈动脉内膜中层厚度的变化  

The change of carotid intima-media thickness in HIV/AIDS patients after highly active antiretroviral therapy

作　　者：苏文晶[1] 王丽萍[1] 杨涤[1] 田云飞[1] 张钰[1] 赵红心[1] 

机构地区：[1]北京大学地坛医院教学医院感染一科,北京100015

出　　处：《国际病毒学杂志》2015年第2期85-89,共5页International Journal of Virology

基　　金：基金项目：十二五国家科技重大专项项目（2012ZX10004-904）;2014年首都卫生发展科研专项项目：HIV/AIDS患者长期抗病毒治疗免疫重建不良机制的研究（2014-2-2173）

摘　　要：目的 探讨HAART后HIV/AIDS患者颈总动脉分叉处内中膜厚度的变化并分析相关因素.方法 我们对40例初治患者和98例正在治疗的患者进行了横断面研究,根据患者的治疗时间将接受治疗的患者分为三组,通过多普勒超声检测颈总动脉分叉处内膜中层厚度、流式技术检测CD4^＋T细胞绝对计数,使用PCR检测血浆病毒载量,收集患者临床资料,如年龄、空腹血脂（包括总甘油三酯、总胆固醇、HDL、LDL）水平、D-二聚体检测值.使用SPSS 19.0对患者各项检查结果进行单因素方差分析.结果 四组患者性别年龄没有统计学差异,治疗前CD4^＋T细胞绝对计数之间的差异具有统计学意义（P＜0.05）,且治疗越早的患者治疗前CD4^＋T细胞绝对计数越低.相比于未治疗的患者,治疗后患者的CD4^＋T细胞绝对计数、颈总动脉分叉处内膜中层厚度、胆固醇水平及HDL水平均升高,血浆病毒载量下降,且差异有统计学意义（P＜0.05）.治疗后患者之间并无统计学差异.结论 HIV/AIDS患者HAART后颈动脉内中膜厚度增厚可能与血脂异常有关,而且可能发生在HAART的早期.Objective To study the impact of highly active antiretroviral therapy on carotid intimamedia thickness and analyze the related factors.Methods A cross-sectional study was carried out on 40 HAART-naive patients and 98 HAART treated patients.We measured carotid intima-media thickness through doppler ultrasound measurement,HIV-1 RNA levels in plasma were measured by PCR,CD4^＋ T cell count were measured by FACS Calibur flow cytometry.We also collected patients＆#39; clinical data,such as age,fasting lipid level（include total triglycerides,total cholesterol,LDL and HDL）,D-dimer level.Oneway ANOVA test was used to statistical analysis.Results The age and gender of the four groups were matched,the initiate CD4^＋T cell between the four groups have statistical differences （P 〈0.05）.The longer the time of the patients received HAART the lower their initiate CD4^＋ T cell count was.Cross-sectional CD4^＋T cell,carotid intima-media thickness,the level of fasting total cholesterol and HDL were all increased,the differences have statistical difference（P 〈 0.05）,HIV-RNA level were decreased and have statistical difference.The significant changes were happened in the first year after HAART,patients after HAART don＆#39; t have statistical differences.The level of fasting triglycerides of the four groups had no statistical differences（P 〉 0.05）.Conclusions The increase of CIMT after HAART may related to the dyslipidemia,and may occur in the early days of HAART.

关 键 词：艾滋病 颈动脉 内膜中层厚度 HAART 

分 类 号：R512.91[医药卫生—内科学]