人血清白蛋白与艾滋病抗病毒疗效关系的病例对照研究  

Study of the relationship between human serum albumin and AIDS antiretroviral efficacy

作　　者：舒远路 杨翠先 张米 李健健 邓雪媚 杨开林 董兴齐 SHU Yuan-lu;YANG Cui-xian;ZHANG Mi;LI Jian-jian;DENG Xue-mei;YANG Kai-lin;DONG Xing-qi(*Yunnan Provincial Infectious Disease Hosspital,Kunming,Yunnan 650301,China;不详)

机构地区：[1]云南省传染病医院,云南昆明650301 [2]怀化市第一人民医院循证医学与临床研究中心,湖南怀化418000

出　　处：《现代预防医学》2020年第10期1900-1903,共4页Modern Preventive Medicine

基　　金：云南省科技计划项目(2016BC005);国家“十三五”科技重大专项课题(2018ZX10721102)。

摘　　要：目的探索抗病毒治疗后人血清白蛋白水平(human serum albumin,HSA)与抗病毒疗效的关系。方法收集抗病毒治疗半年以上的病毒学失败HIV/AIDS患者,以性别、年龄、抗病毒治疗时间和治疗方案等条件按1∶1配对收集病毒学抑制成功的对照组患者,采用条件logistic回归分析。结果根据匹配条件共获得178对患者,男性占66.29%,女性占33.71%。在未调整变量前,OR为0.764(95%CI 0.696-0.838)。调整基线HSA、基线CD4+T淋巴细胞和治疗24周后CD4+T淋巴细胞后,OR为0.780(95%CI 0.703-0.866),HSA与抗病毒疗效存在负关联,高HSA可能为抑制病毒血症的保护因素。在一线方案AZT/3TC/EFV、TDF/3TC/EFV和AZT/3TC/NVP也发现HSA与抗病毒疗效存在负关联,而在二线方案TDF/3TC/LPVr、AZT/3TC/LPVr未发现此现象。结论抗病毒治疗失败与低血清白蛋白水平有关,HIV/AIDS患者在临床治疗过程中,应加强血清白蛋白的监测。Objective To explore the relationship between human serum albumin(HSA)concentration after antiretroviral therapy(ART)and ART effect.Methods HIV/AIDS patients with failure ART have treated for more than 6 months were collected from the follow-up clinic of AIDS treatment,which matched by gender,age,ART time and treatment plan.This study used a 1:1 case-control study and the conditional logistic regression analysis.Results A total of 178 pairs of patients were obtained according to the matching conditions.The males and females were 66.29%and 33.71%,respectively.Before unadjusted variables,OR is 0.764(95%CI 0.696-0.838).After adjusted baseline HSA,baseline CD4+T lymphocytes and CD4+T lymphocytes after 24 weeks treatment,OR was 0.780(95%CI 0.703-0.866),HSA has negative correlation with antiviral efficacy,and high HSA may be a protective factor for inhibiting viremia.In the first-line regimen such as AZT/3TC/EFV,TDF/3TC/EFV and AZT/3TC/NVP were also found to be negatively correlated with antiviral efficacy,while in the second-line regimen such as TDF/3TC/LPVr and AZT/3TC/LPVr,no such phenomenon was found.Conclusion The failure of ART is related to the decrease of HSA concentration.Monitoring of serum albumin in HIV/AIDS patients should be strengthened.

关 键 词：人类免疫缺陷病毒1型 白蛋白 病毒载量 

分 类 号：R181.3[医药卫生—流行病学]