以克力芝为基础的初始抗病毒治疗方案对成人HIV/AIDS病人血脂的影响  

Effect of antiviral therapy regimen based on Kaletra on blood lipid:a retrospective clinical study in adult patients with HIV/AIDS

作　　者：代丽丽[1] 叶江竹[1] 邵英[1] 李建维[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,北京100069

出　　处：《中国艾滋病性病》2017年第9期806-809,共4页Chinese Journal of Aids & STD

基　　金：北京市医院管理局"青苗"计划专项经费资助(QML20161702);国家自然科学基金项目(81601795)~~

摘　　要：目的了解以克力芝为基础的初始抗病毒治疗方案,对成人艾滋病病毒(HIV)感染者/艾滋病(AIDS)病人(简称HIV/AIDS病人)血脂的影响。方法回顾性分析2010年10月至2015年10月间,北京佑安医院以克力芝作为初始抗病毒治疗药物的106例HIV/AIDS病人的血清总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白(LDL)、高密度脂蛋白(HDL)以及TC/HDL比值的数据,比较抗病毒治疗前后血脂的变化特点。结果 106例HIV/AIDS病人抗病毒治疗前总的血脂异常率为74.5%,其中TG、TC、HDL、LDL和TC/HDL异常的HIV/AIDS病人百分比分别为31.1%、9.4%、49.1%、6.6%和18.9%;抗病毒治疗后总的血脂异常率为89.6%,TG、TC、HDL、LDL和TC/HDL异常HIV/AIDS病人的百分比分别为63.2%、16.0%、56.6%、5.7%和21.7%。与基线比较,TG升高的HIV/AIDS病人比例从31.1%到63.2%(P<0.001),且其数值水平中位数从1.2mmol/L升高到1.93mmol/L(P<0.001);TC在治疗后数值中位数从4.06mmol/L升高到4.32mmol/L,但异常HIV/AIDS病人百分比的变化无统计学意义(P>0.001);作为动脉粥样硬化性心血管疾病(ASCVD)最重要的预警指标的LDL,在治疗后并没有升高。结论以克力芝为基础的初始抗病毒治疗方案可以影响病人的血脂代谢,但仅对TG和TC的影响比较明显,而对于ASCVD最主要危险因素的LDL的影响较小。Objective To investigate the effect of initial antiviral therapy （ART） regimen based on Kaletra on blood lipids in adult patients with HIV/AIDS. Methods A retrospective study was conducted in 106 adult HIV/ AIDS patients receiving Kaletra contained ART regimen in Beijing You＇ an hospital from October 2010 to October 2015 and to compare the difference on lipids before and after ART. Results 74.5% of 106 patients had dyslipidemia as a baseline before ART, and the rate increased after ART. The medians of TG and TC increased with the difference statistically significant before and after ART. The difference of TG and TC medians of the patients with ART,I year and 1 year was also statistically significant. And the increasing rate of patients with TG was statis- tically significant. We did not find the difference on TG, TC, LDL and TC/HDL between the two groups with or without TDF before and after ART. Conclusion The study shows that ART regimens based on Kaletra on blood lipids have significant effects on TG and TC and smaller effect on LDL, the most important risk factor for ASCVD.However, all of the blood lipids after ART display a certain degree of increase, and it is recommended that patients with ART regimens based on Kaletra should receive testing of blood lipids more frequently so as to be alert to ischemic cardiovascular disease.

关 键 词：艾滋病病毒感染者/艾滋病病人 克力芝 抗病毒治疗 血脂 

分 类 号：R512.91[医药卫生—内科学] R373.9[医药卫生—临床医学]