306例艾滋病患者的血脂异常情况及相关因素分析  

Dyslipidemia and relevant factors analysis of HIV/AIDS patients in general hospital

作　　者：余旻虹[1] 赵艳伟[1] 杨慧[1] 宋晓璟[1] 何叶[1] 李佳倩[1] 张小娟[1] Yu Minhong;Zhao Yanwei;Yang Hui;Song Xiaojing;He Ye;Li Jiaqian;Zhang Xiaojuan(Peking Union Medical College Hospital,Peking Union Medical College and Chinese Academy of Medical Sciences,Beijing 100730,China)

机构地区：[1]中国医学科学院北京协和医院,北京100730

出　　处：《中华实验和临床病毒学杂志》2020年第2期122-127,共6页Chinese Journal of Experimental and Clinical Virology

基　　金：中华护理学会科研课题(ZHKY201610)。

摘　　要：目的分析艾滋病(AIDS)患者的血脂异常情况及相关因素。方法纳入分析了2017年4月至2018年1月在北京协和医院感染科就诊的306例AIDS患者,对患者的一般资料、一般自我效能感量表、社会支持评定量表、国际体力活动短问卷和高脂血症患者膳食评价4个量表进行调查。结果306例患者中血脂异常179名(58.50%),单因素分析结果为非核苷类逆转录酶抑制剂较其他抗病毒药物对血脂的影响更小(χ^2=10.710,P=0.001),蛋白酶抑制剂较其他药物对血脂的影响更大(χ^2=12.559,P<0.001);血脂异常组的患者较正常组患者年龄、BMI更大。已婚者血脂水平存在差异。多因素分析结果为饮食习惯与女性性别、活动等级与BMI、年龄与病程在血脂异常中存在交互作用。结论AIDS患者的血脂异常更多程度是由疾病本身及治疗造成的。医护人员在随访过程中尤其应关注使用蛋白酶抑制剂者、病程超过两年者、中年以上患者、初治时CD4计数高的特殊患者。Objective To investigate dyslipidemia and relevant factors of AIDS patients in general hospital.Methods From April 2017 to January 2018,306 AIDS patients seen in Peking Union Medical College Hospital(PUMCH)were included,their general information such as demographic characteristics,underlying diseases,regimens for treatment and duration of antiretroviral therapy were recorded and dietary conditions were evaluated.General Self-Efficacy Scale(GSES),Social Support Rating Scale(SSRS),Internal Physical Activity Questionnaire(IPAQ)were adopted for the investigation.Results Of the 306 patients,179 had dyslipidemia.Univariate analysis suggested that singlehood,higher age and body mass index(BMI),proteinase inhibitor(PI)and non-nucleotide reverse transcriptase inhibitor(NNRTI)contained antiretroviral therapy(ART)(especially the former)were relevant risk factors.After multivariable analysis,higher age and BMI,high fat diet,high baseline CD4 counting and longer course of disease were related with dyslipidemia,whereas female and higher activity level may be associated with little benefit.Conclusions Dyslipidemia was more common in AIDS patients than in general population,which were mainly due to the disease itself and ART regimens.Those patients were middle-aged or older,with high baseline CD4 counting,treated with PI and whose course of disease was more than two years should reserve more attention.

关 键 词：艾滋病 血脂异常 抗逆转录病毒治疗 生活方式 

分 类 号：R51[医药卫生—内科学]