初治人类免疫缺陷病毒感染者合并代谢综合征及心血管病风险状况及其临床特点分析  

A study of metabolic syndrome and cardiovascular disease risk status in highly active antiretroviral therapy-naive patients with human immunodeficiency virus infection

作　　者：王延雪 胡虹英 李新刚 鹿星梦 郜桂菊[2] 梁洪远[2] 肖江[2] 杨涤[2] 王芳[2] 韩晓涛 Wang Yanxue;Hu Hongying;Li Xingang;Lu Xingmeng;Gao Guiju;Liang Hongyuan;Xiao Jiang;Yang Di;Wang Fang;Han Xiaotao(Department of Endocrinology,Beijing Ditan Hospital,Capital Medical University,Beijing 100015,China;Division 1 of Infection Disease,Beijing Ditan Hospital,Capital Medical University,Beijing 100015,China;Department of Cardiology,Beijing Ditan Hospital,Capital Medical University,Beijing 100015,China)

机构地区：[1]首都医科大学附属北京地坛医院内分泌科,北京100015 [2]首都医科大学附属北京地坛医院感染一科,北京100015 [3]首都医科大学附属北京地坛医院心内科,北京100015

出　　处：《首都医科大学学报》2020年第1期40-44,共5页Journal of Capital Medical University

基　　金：“十三五”艾滋病和病毒性肝炎等重大传染病防治科技重大专项(2017ZX10202101004)~~

摘　　要：目的探讨尚未进行高效抗反转录病毒治疗(highly active antiretroviral therapy,HAART)的人类免疫缺陷病毒(human immunodeficiency virus,HIV)感染者代谢综合征(metabolic syndrome,MS)及心血管病风险状况及其临床特点。方法以HIV感染者193人为研究对象,按照MS的诊断标准选择诊断为MS的患者为MS组,选对应的非MS患者为非MS组;按照Framingham风险评分筛选心血管病中高危患者为中高危组,低危者为低危组。分别比较2组的临床特征。结果本研究中代谢综合征的患病率为9.33%,MS各组分中比例最大的为体质量指数(body mass index,BMI)≥25 kg/m^2,其次为高密度脂蛋白胆固醇降低。与对照组相比,代谢综合征患者年龄更高,BMI较大,差异有统计学意义(P<0.05);MS患者的心血管病风险明显高于非MS患者,年龄、BMI和吸烟史与初治HIV感染者心血管病风险有关,冠状动脉粥样硬化性心脏病风险评估为中高危组患者HIV RNA载量更高,但差异无统计学意义。结论年龄与BMI与初治HIV感染者代谢综合征风险有关,MS患者心血管病风险明显高于非MS者。HAART治疗前需评估相关危险因素,密切监测并控制患者代谢紊乱及心血管疾病。Objective To investigate the clinical characteristics as well of metabolic syndrome(MS)and risk status of cardiovascular disease in highly active antiretroviral therapy(HAART)-naive patients with human immunodeficiency virus(HIV)infection.Methods With 193 HIV infected patients as the study subjects,patients with(case group)and without(control group)MS were identified according to the MS diagnostic criteria,According to the Framingham risk score,patients with high risk of cardiovascular disease were selected as middle and high risk group,and those with low risk were selected as low risk group.Clinical characteristics were analysed by comparing the two groups.Results In our research,the prevalence of MS was 9.33%.The largest component was body mass index(BMI)≥25 kg/m^2,followed by a decrease in high density lipoprotein cholesterol(HDL-C).Compared with the control group,patients with MS were older,and they had larger body mass index(BMI)(P<0.05).The cardiovascular risk of MS patients was significantly higher than those without MS.Age,BMI and smoking history were associated with cardiovascular risk in newly diagnosed HIV patients.Patients at high risk of coronary heart disease had higher HIV RNA load,but the difference was not statistically significant.Conclusion Age and BMI were associated with the risk of metabolic syndrome.Cardiovascular risk of MS patients was significantly higher than those without MS.Related risk factors should be evaluated before HAART,and metabolic disorders and cardiovascular diseases should be closely monitored.

关 键 词：人类免疫缺陷病毒 初治 代谢综合征 心血管风险 

分 类 号：R589[医药卫生—内分泌]