含齐多夫定的HAART方案致艾滋病患者贫血的发生时间及危险因素分析  

Analysis of the occurrence time and risk factors of anemia in AIDS patients caused by HAART regimen containing zidovudine

作　　者：颜海燕 何文明 李国贤 罗科瑜 覃湘松 韦慧芬 张鹏[2,3,4] 蒋忠胜 YAN Haiyan;HE Wenming;LI Guoxian;LUO Keyu;QIN Xiangsong;WEI Huifen;ZHANG Peng;JIANG Zhongsheng(Graduate School of Youjiang Medical College for Nationalities,Guangxi Baise 533000,China;Dept.of Infectious Diseases,Liuzhou Municipal People’s Hospital,Guangxi Liuzhou 545006,China;Liuzhou Key Laboratory of Infectious Disease Immunity Research,Guangxi Liuzhou 545006,China;Guangxi Key Laboratory of Clinical Disease Biotechnology Research,Guangxi Liuzhou 545006,China)

机构地区：[1]右江民族医学院研究生学院,广西百色533000 [2]柳州市人民医院感染病科,广西柳州545006 [3]柳州市传染病免疫研究重点实验室,广西柳州545006 [4]广西临床疾病生物技术研究重点实验室,广西柳州545006

出　　处：《中国药房》2023年第21期2620-2624,共5页China Pharmacy

基　　金：“十三五”艾滋病和病毒性肝炎等重大传染病防治——艾滋病机会性感染及难治性艾滋病的精准诊治策略研究课题(No.2018ZX10302104-001);广西壮族自治区卫生健康委员会自筹经费科研课题(No.Z-B20221305);柳州市科技计划项目(No.2022SB009)。

摘　　要：目的 考察艾滋病(AIDS)患者使用含齐多夫定的高效抗逆转录病毒治疗(HAART)方案后发生贫血的时间及危险因素。方法 收集2010年1月1日至2022年12月31日在柳州市人民医院关爱门诊随访的2 150例AIDS患者的临床资料,采用回顾性分析的方法考察患者出现贫血的时间,并采用单因素分析和二元Logistic回归分析方法考察患者出现贫血的危险因素。结果 共纳入854例接受含齐多夫定的HAART方案治疗的AIDS患者资料,有107例(12.53%)发生了贫血,其中大多数患者(63.55%)是在用药后3个月内出现贫血的。基线血红蛋白[OR=2.944,95%CI(1.195,7.501),P=0.019]、基线CD4^(+)T淋巴细胞计数[OR=2.472,95%CI(1.117,5.469),P=0.026]和基线人类免疫缺陷病毒载量[OR=4.299,95%CI(1.905,9.705),P<0.001]与患者发生贫血存在相关性。结论 使用含齐多夫定的HAART方案的AIDS患者发生贫血的中位时间是开始治疗后2个月。基线血红蛋白≤110 g/L、基线CD4^(+)T淋巴细胞计数≤100个/mm^(3)以及基线人类免疫缺陷病毒载量≥100 000 copies/mL是该类患者发生贫血的独立危险因素。OBJECTIVE To investigate the occurrence time and risk factors of anemia in patients with acquired immune deficiency syndrome(AIDS)after taking highly active antiretroviral therapy(HAART)containing zidovudine.METHODS The clinical data of 2150 AIDS patients who were followed up in the care clinic of Liuzhou People’s Hospital from January 1,2010 to December 31,2022 were collected.The occurrence time of anemia was analyzed retrospectively,and the risk factors of anemia were analyzed by univariate analysis and binary Logistic regression analysis.RESULTS A total of 854 AIDS patients receiving HAART containing zidovudine were collected,and 107 patients(12.53%)developed anemia.Most of them(63.55%)developed anemia within 3 months after treatment.Baseline hemoglobin[OR=2.944,95%CI(1.195,7.501),P=0.019],baseline CD4+T lymphocyte count[OR=2.472,95%CI(1.117,5.469),P=0.026]and baseline human immunodeficiency virus-ribonucleic acid(HIV-RNA)[OR=4.299,95%CI(1.905,9.705),P<0.001]was associated with anemia.CONCLUSIONS The median time of anemia in AIDS patients receiving HAART containing zidovudine is the second month after initiation of treatment.Baseline hemoglobin≤110 g/L,baseline CD4^(+)T lymphocyte count≤100/mm^(3),and baseline HIV-RNA≥100000 copies/mL are independent risk factors for anemia in these patients.

关 键 词：齐多夫定 艾滋病 人类免疫缺陷病毒 高效抗逆转录病毒治疗 贫血 危险因素 

分 类 号：R969.3[医药卫生—药理学] R512.91[医药卫生—药学]