HARRT联合复方新诺明对艾滋病患者机会性感染的预防作用  

Preventive effect of HARRT combined with SMZ-TMP on opportunistic infection in AIDS patients

作　　者：缪旭敏 刘青青[1] MIAO Xu-min;LIU Qing-qing(Department of Pharmacy,Nantong Third People′s Hospital,Nantong,Jiangsu 226006,China)

机构地区：[1]江苏省南通市第三人民医院药剂科,江苏南通226006

出　　处：《公共卫生与预防医学》2021年第6期103-106,共4页Journal of Public Health and Preventive Medicine

摘　　要：目的探讨高效抗逆转录病毒治疗(Highly active antiretroviral therapy,HARRT)联合复方新诺明(Paediatric Compound Sulfamethoxazole Tablets,SMZ-TMP)对艾滋病(human immunodeficiencyvirus/Acquired immunodeficiency syndrome,HIV/AIDS)患者机会性感染(Opportunistic Infections,OIs)的预防作用。方法回顾性选取南通市第三人民医院170例AIDS患者,所有患者均接受HARRT。根据是否使用SMZ-TMP进行OIs预防性治疗,分为预防组(n=47)和未预防组(n=123)。比较两组OIs发生率,并分析SMZ-TMP对OIs的预防作用。结果预防组OIs发生率显著低于未预防组,差异有统计学意义(χ^(2)=9.062,P<0.05),两组OIs发生数量构成比比较,差异有统计学意义(χ^(2)=7.419,P<0.05)。预防组细菌性肺炎、肺结核、肺外结核病、PCP和真菌性口炎发生率明显低于未预防组,差异有统计学意义(χ^(2)=4.473、4.322、4.350、3.982、5.656,P<0.05)。单因素和多因素非条件logistic回归分析显示,认为SMZ-TMP治疗有益、医生详细推荐SMZ-TMP和受教育程度较高均是促进AIDS患者服用SMZ-TMP的影响因素(95%CI:135.79~3748.36、107.43~2954.67、1.873~25.94)。结论预防性使用SMZ-TMP可显著减少AIDS相关OIs发生,但SMZ-TMP的使用比重偏低,需根据服用SMZ-TMP的影响因素采取相关措施。Objective To investigate the preventive effect of highly effective antiretroviral therapy(HARRT)combined with SMZ-TMP on opportunistic infection(OIs)in patients with HIV/AIDS.Methods The 6-month follow-up data of 170 AIDS patients in the Department of Infectious Diseases of Nantong Third People′s Hospital were analyzed retrospectively.All patients received HARRT.According to whether SMZ-TMP was used for OIs preventive treatment,the patients were divided into a prevention group(n=47)and a non-prevention group(n=123).The demographic data such as gender,age,occupation and education level of the two groups were collected.The incidence of OIs in the 12-month follow-up period of the two groups was analyzed and compared,and the single factor unconditional logistic regression analysis and multi factor unconditional logistic regression analysis were carried out for AIDS patients taking SMZ-TMP.Results The proportion of prophylactic use of SMZ-TMP in 170 AIDS patients was only 27.65%,and the incidence of OIs in the prevention group was 31.91%,which was significantly lower than that in the non-prevention group(57.72%)(χ^(2)=9.062,P<0.05).Among the 15 patients with OIs in the prevention group,the proportion of patients with one,two to three and more than three types of OIs accounted for 64.71%,23.53%and 4.26%,respectively,while those in the non prevention group were 30.99%,38.03%and 30.98%,respectively.There was a significant difference in the composition ratio between the two groups(χ^(2)=7.419,P<0.05).The incidences of bacterial pneumonia,tuberculosis,extrapulmonary tuberculosis,PCP and fungal stomatitis in the prevention group were 18.89%,10.64%,4.26%,6.38%and 4.26%,respectively,which were significantly lower than those in the non-prevention group(30.89%,25.20%,16.26%,18.70%and 18.70%,respectively)(χ^(2)=4.473,4.322,4.350,3.982,5.656,P<0.05).Univariate and multivariate unconditional logistic regression analysis showed that the benefits of SMZ-TMP,doctors′detailed recommendation of SMZ-TMP and higher education level

关 键 词：艾滋病 高效抗逆转录病毒治疗 复方新诺明 机会性感染 预防作用 

分 类 号：R181[医药卫生—流行病学] R512.91[医药卫生—公共卫生与预防医学]