艾滋病二线抗病毒治疗方案的疗效和安全性临床观察  

Clinical observation of efficacy and safety of second-line antiretroviral therapy in HIV/AIDS

作　　者：刘安[1] 李建维[1] 叶江竹[1] 邵英[1] 贺亮[1] 马红丽[1] 孙丽君[1] 

机构地区：[1]首都医科大学附属北京佑安医院感染中心,北京100069

出　　处：《中国艾滋病性病》2015年第6期450-452,共3页Chinese Journal of Aids & STD

基　　金：国家自然科学基金(81273136);国家十二五课题(2013ZX10001002-001);北京市医院管理局临床医学发展专项经费(ZY201401);国家卫计委2014重点建设专科项目资助课题(WJWYA-2014-006)~~

摘　　要：目的评价二线抗反转录病毒治疗方案治疗艾滋病(AIDS)病人的疗效及安全性。方法对2012年1月至2013年12月,首都医科大学附属北京佑安医院感染中心接收的、用二线抗病毒治疗方案治疗的268例艾滋病病毒(HIV)感染者/AIDS病人,进行治疗后的病毒学和免疫学疗效及治疗安全性分析。结果 268例病人平均年龄(36.7±9.7)岁,其中男性占80.2%(215人),通过男男性行为传播占60.4%(162人)。在治疗48周后,病毒载量<50拷贝/mL者的比例由30.2%增加至84.3%,CD+4T淋巴细胞数量由基线(319±200)个/μL逐渐升高至(374±183)个/μL(12周)、(401±170)个/μL(24周)和(463±176)个/μL(<48周),与基线比差异均有统计学意义(P均<0.0001)。共有49例病人发生75次不良反应,其中血脂异常占41.3%(31/75),消化道症状占36.0%(27/75),多为轻中度不良反应。结论现行艾滋病二线抗病毒治疗方案的病毒学和免疫学疗效均较好,安全性可接受,但在临床应用中应注意血脂异常和消化道症状等不良反应。Objective To evaluate the efficacy and safety of the second-line antiretroviral regimens in human im- munodeficiency virus （HIV）/acquired immunodeficiency syndrome （AIDS） patients. Methods The study enrolled a total of 268 HIV/AIDS patients who started the second-line antiretroviral therapy from January 2012 to December 2013 in the Center for Infectious Diseases of Beijing You An Hospital, Capital Medical University. Virological and immunological efficacy and safety of treatment were analyzed. Results The average age of the 268 patients was （36.7~9.7） years, and the males accounted for 80.2% （215 cases）. Transmission through male homosexual be- havior accounted for 60.4% （162 cases ）. After 48 weeks of treatment, the proportion of patients with viral load 〈50 copies/mL increased from 30.2% at baseline to 84.3%, and the mean CD4 cell counts gradually increased from 319±200μL at baseline to 374±183/μL （12 weeks）, 401±170/μL （24 weeks） and 463~ 176/μL （48 weeks）.They all had statistical significances compared with baseline levels （all P＇~0. 0001）. There were a total of 75 adverse reactions in 49 patients, in which dyslipi- demia accounted for 41.3% （31/75）, and gastrointes- tinal symptoms accounted for 36.0% （27/75）. Most adverse reactions were mild to moderate. Conclusion The second-line antiretroviral therapy was virologically and immunologically effective, and the safety was ac- ceptable, but the side effects including dyslipidemia and gastrointestinal discomforts should be noted.

关 键 词：艾滋病病感染者/艾滋病病人 二线抗反转录病毒治疗方案 疗效 安全性 

分 类 号：R512.91[医药卫生—内科学]