人类免疫缺陷病毒感染者高效抗逆转录病毒治疗后生化计量指标的变迁  

The characteristics and changing of the biochemical measurement of AIDS after highly active antiretroviral therapy

作　　者：梁林慧[1] 余飞[1] 黄承乐[1] 农世泽[1] 班副植[1] 陆义明 Liang Linhui;Yu Fei;Huang Chengle;Nong Shize;Ban Fuzhi;Lu Yiming(Clinical Laboratory,Baise People's Hosptial,Baise,Guangxi,533000,China)

机构地区：[1]百色市人民医院检验科,广西百色533000

出　　处：《当代医学》2018年第11期5-8,共4页Contemporary Medicine

摘　　要：目的探讨高效抗逆转录病毒治疗后艾滋病患者机体内代谢功能生化计量指标的变化特征及影响。方法选择2013年10月~2016年10月在本院门诊进行HAART治疗的AIDS患者300例,分别监测治疗3年来患者机体在血脂代谢、胆汁代谢、肝功能、血糖代谢、肾功能、乳酸代谢等代谢方面的生化计量指标,分析其产生的原因。结果 300例艾滋病患者接受HAART治疗后,3年以来患者在上述代谢功能的生化计量指标上的表现均出现不同程度的变化。主要表现在血脂代谢异常、胆汁代谢异常、肝功能异常。其中,以甘油三酯(TG)增高为主,增高5倍,其次为低密度脂蛋白(LDL-C)和胆固醇(TC),增高2倍。而高密度脂蛋白(HDL-C)则下降2倍。其他的代谢检测项目中,乳酸(LAC)增高4倍,淀粉酶和血糖则分别增加2倍和1倍。肝功能的生化计量指标与治疗前比较,以总胆汁酸(TBA)增高尤为显著,增高10倍。其次为总胆红素(BIL-T),增高4倍,而γ-谷氨酰转肽酶(GGT)则增高2倍。以上代谢指标的变化经统计显示差异有统计学意义(P<0.05)。结论艾滋病患者接受HAART治疗后,随着治疗时间的延长,患者机体内受病毒和治疗药物的共同毒性影响下,出现了代谢综合征,导致机体在血脂、肝功能、血糖、乳酸等代谢功能方面的生化计量指标发生了变化。本研究结果提示,艾滋病患者在HAART治疗前后在常规生化计量指标基础上扩大其他指标的监测,及时发现代谢综合征及引起心血管病变的危险生化计量指标,为干预性治疗提供依据。Objective To investigate the characteristics and changing of the biochemical measurement of metabolic function among patients accepted highly active antiretroviral therapy(HAART).Methods Choose 300 cases of outpatients in our hospital whom accepted HAART from October 2013 to October 2016,Constant monitor the biochemical measurement of case's lipid metabolism,bile metabolism,liver function,blood glucose metabolism,kidney function and lactic acid metabolism,then analyze the causes.Results The biochemical measurement of cases shows varying degrees of change during three years of HAART.The change mainly manifested in lipid metabolism,bile metabolism and liver function.Among them,the biggest change is Triglyceride,it’s five times higher.The secondly change are low density Lipoprotein(LDL-C)and Cholesterol(TC),they are 2 times higher.However,the value of High density lipoprotein(HDL-C)is 2 times higher.In the other metabolic testing programs,the value of Lactic acid(LAC)is 2 times higher,Amylase is 1times higher and Glucose is 2 times higher.Compare the biochemical measurement of Liver function between before and after HAART,Total bile acid(TBA)had the highest growth rate,it's 10 times higher.The secondly is Total bilirubin(BIL-T),it’s 4 times higher,however,Gamma-glutamyltransferase(GGT)is 2 times higher.The metabolic indices changed above has statistically significant(P<0.05).Conclusion AIDS patients after accepted HAART,as long as the HAART proceed,it might cause adverse drug reaction which would effecting the metabolism of the body,including lipid metabolism,bile metabolism,liver function,blood glucose metabolism and kidney function.The results of this study shows,AIDS patients during HAART need to expanding monitoring of other indicators based on biochemical measurement,in order to discovering metabolic syndrome and biochemical indicators which can reflect cardiovascular disease in time.

关 键 词：高效逆转录治疗 免疫缺陷综合征 代谢综合征 

分 类 号：R512.91[医药卫生—内科学]