高效抗逆转录病毒治疗后脂肪分布异常HIV/AIDS患者的HIV相关神经认知功能障碍发生情况及其影响因素  

Incidence of HIV-associated neurocognitive disorder and its influencing factors in HIV/AIDS patients with lipodystrophy after highly active antiretroviral therapy

作　　者：黎彦君[1] 熊燕 黄金萍[1] 黄秀金[1] 欧健[1] 吴念宁[1] LI Yan-jun;XIONG Yan;HUANG Jin-ping;HUANG Xiu-jin;OU Jian;WU Nian-ning(Nanning Fourth People′s Hospital,Nanning 530023,China)

机构地区：[1]广西南宁市第四人民医院,南宁市530023

出　　处：《广西医学》2020年第9期1080-1084,共5页Guangxi Medical Journal

基　　金：广西南宁市科学研究与技术开发计划(20163115)。

摘　　要：目的分析高效抗逆转录病毒治疗(HAART)后出现脂肪分布异常的HIV/AIDS患者的HIV相关神经认知功能障碍(HAND)发生情况及其影响因素。方法将HAART后出现脂肪分布异常的40例HIV/AIDS患者纳入观察组,无脂肪分布异常的40例HIV/AIDS患者为对照组。采用蒙特利尔认知评估(MoCA)量表评定所有患者的认知功能评估。比较观察组与对照组间,以及观察组内HAND患者与非HAND患者间临床资料的差异。分析观察组发生HAND的影响因素。结果观察组体质指数、MoCA总分均低于对照组(P<0.05),但HAND发生率及其他资料差异均无统计学意义(均P>0.05)。观察组中,与非HAND者比较,HAND者年龄更大,基线及入组时CD4+T淋巴细胞计数更低(均P<0.05)。Logistic回归分析显示,年龄增加、基线CD4+T淋巴细胞计数降低是观察组患者发生HAND的危险因素(均P<0.05)。结论HAART后出现脂肪分布异常的HIV/AIDS患者HAND发生率较高,其认知功能差于无脂肪分布异常者,其中年龄较大、CD4+T淋巴细胞低下的患者更易出现HAND。Objective To analyze the incidence of HIV-associated neurocognitive disorder(HAND)and its influencing factors in HIV/AIDS patients with lipodystrophy after highly active antiretroviral therapy(HAART).Methods Forty HIV/AIDS patients who suffered from lipodystrophy after HAART were enrolled in observation group,and 40 HIV/AIDS patients without lipodystrophy as control group.The Montreal Cognitive Assessment(MoCA)scale was used to assess the cognitive function in all patients.Clinical data were compared between the observation group and the control group,or patients with and without HAND in the observation group.The influencing factors of developing HAND were analyzed in the observation group.Results The observation group had lower body mass index and total MoCA score than the control group(P<0.05),but there was no statistically significant difference in incidence rate of HAND or other data between the two groups(all P>0.05).In the observation group,compared with patients without HAND,those with HAND had older age,lower baseline and enrollment CD4+T lymphocyte counts(all P<0.05).Logistic regression analysis revealed that age increment and decline in baseline and enrollment CD4+T lymphocyte counts were the risk factors for developing HAND in patients in the observation group(all P<0.05).Conclusion HIV/AIDS patients who suffer from post-HAART lipodystrophy have poor cognitive function than those without lipodystrophy,with a higher incidence rate of HAND,among whom patients with older age or deficient CD4+T lymphocytes are more likely to experience HAND.

关 键 词：人类免疫缺陷病毒感染 获得性免疫缺陷综合征 脂肪分布异常 高效抗逆转录病毒治疗 认知功能 神经认知功能障碍 

分 类 号：R512.91[医药卫生—内科学]