司他夫定联合拉米夫定与奈韦拉平抗病毒方案治疗对艾滋病患者免疫功能的影响及其安全性分析  

The immune function effect and safety analysis of D4T + 3TC + NVP anti-virus solution treatment for patients with HIV/AIDS

作　　者：白一春 李骁[1] 夏仁兴 

机构地区：[1]四川省广安市人民医院感染科,四川广安638550

出　　处：《临床和实验医学杂志》2018年第1期63-67,共5页Journal of Clinical and Experimental Medicine

摘　　要：目的探讨司他夫定(D4T)+拉米夫定(3TC)+奈韦拉平(NVP)抗病毒方案治疗对艾滋病患者免疫功能的影响及其安全性。方法选取2014年1月至2016年1月期间符合抗病毒方案治疗标准且经D4T+3TC+NVP抗病毒方案治疗的艾滋病患者80例作为研究组,同期选取尚未达到抗病毒方案治疗标准的艾滋病患者80例作为对照组。比较两组免疫功能、HIV病毒载量与药物安全性的差异。结果治疗前,研究组CD4^+T淋巴细胞计数明显低于对照组(P<0.05),治疗后,研究组CD4^+T淋巴细胞计数明显高于对照组与治疗前(P<0.05),而对照组治疗前后CD4^+T淋巴细胞计数比较差异无统计学意义(P>0.05)。治疗前,研究组HIV病毒载量明显高于对照组(P<0.05),治疗后,研究组HIV病毒载量明显低于对照组与治疗前(P<0.05),而对照组治疗前后HIV病毒载量检测结果比较,差异无统计学意义(P>0.05)。研究组HIV病毒抑制率明显高于对照组,两组比较差异具有统计学意义(P<0.05)。治疗期间发生胃肠道不适、头晕乏力、肝功能障碍、皮疹、周围神经损害、乳酸酸中毒、胰腺炎与脂肪分布异常等轻中度不良反应,并经对症处理后好转,无病死案例。结论 D4T+3TC+NVP抗病毒方案治疗艾滋病患者的临床疗效满意,有助于改善免疫功能,且药物安全性较高,值得临床推广应用。Objective To study the immune function effect and safety of Stavudine （D4T）＋ Lamivudine（3TC）＋ Nevirapine （NVP） anti - virus solution treatment for patients with HIV/ AIDS. Methods 80 cases of patients with HIV/ AIDS reached antiviral regimen standard and given D4T ＋ 3TC ＋ NVP antiviral solution treatment during the period of January 2014 and January 2016 from infectious in - patient department of our hospital were selected as study group,80 cases of patients with HIV/ AIDS not yet reached antiviral regimen standard in the same period were selected as control group. The difference of immune function,HIV viral load and drug safety between the two groups were compared. Results Be-fore treatment,CD4 ＋ T lymphocyte count was significantly lower than that of the control group （P 〈 0. 05）,after treatment,CD4 ＋ T lymphocyte count of study group was significantly higher than control group and pre - therapy （P 〈 0. 05）,CD4 ＋ T lymphocyte counts of control group com-pared pre - therapy and post - therapy with no statistically significant difference （P 〉 0. 05）. Before treatment,HIV viral load of study group was significantly higher than that of control group （P 〈 0. 05）,after treatment,HIV viral load of study group was significantly lower than that of the control group and pre - therapy （P 〈 0. 05）,while HIV viral load of control group compared pre - therapy and post - therapy with no statistically significant difference （P 〉 0. 05）. HIV virus inhibition rate of study group was significantly higher than that of the control group with statistically significant difference （P 〈 0. 05）. During the treatment,mild - to - moderate adverse reactions of gastrointestinal discomfort,dizziness,fatigue, liver dysfunction,rash,peripheral nerve damage,lactic acidosis,pancreatitis and abnormal fat distribution were occurred,and by symptomatic treatment were improved. There was no death case. Conclusion The curative effect of D4T ＋ 3TC ＋ NVP anti - virus solution treatm

关 键 词：艾滋病 司他夫定 拉米夫定 奈韦拉平 抗病毒治疗 免疫功能 

分 类 号：R512.91[医药卫生—内科学]