HIV感染者脑白质高信号分级的影响因素分析  

Analysis on factors influencing the severity grading of white matter hyperintensities in HIV-infected patients

作　　者：宣伟玲 侯艳春 张燕[1] 李运江 陈祖华[1] 丁忠祥 XUAN Weiling;HOU Yanchun;ZHANG Yan;LI Yunjiang;CHEN Zuhua;DING Zhongxiang(Department of Radiology,Hangzhou Xixi Hospital Affiliated to Zhejiang Chinese Medical University,Hangzhou 310023,China;不详)

机构地区：[1]浙江中医药大学附属杭州市西溪医院放射科,310023 [2]杭州市第一人民医院放射科

出　　处：《浙江医学》2024年第14期1535-1539,共5页Zhejiang Medical Journal

基　　金：浙江省中医药科技计划项目(2024ZL758)。

摘　　要：目的分析影响HIV感染者脑白质高信号(WMH)严重程度分级的因素。方法回顾性收集2016年1月至2022年12月在浙江中医药大学附属杭州市西溪医院确诊为HIV感染并行颅脑MRI检查的176例患者,按照WMH严重程度分级分为Ⅰ级129例、Ⅱ级35例、Ⅲ级12例。观察并记录患者WMH分布情况,比较3组患者一般临床资料及各项实验室检查资料,分析影响WMH分级的因素。结果多数HIV感染者WMH同时存在于脑室旁及脑深部,一些位于脑深部。WMH脑深部发生率为88.64%,脑室旁发生率为68.75%。3组患者TG、联合抗反转录病毒治疗(cART)时间比较,差异均有统计学意义(均P<0.05)。多因素logistic回归分析显示,cART时间(OR=1.007,95%CI:1.000~1.015,P=0.047)是影响HIV感染者WMH严重程度分级的独立危险因素。结论HIV感染者脑深部较脑室旁更容易发生WMH;cART时间是影响HIV感染者WMH分级的独立危险因素,可能加重HIV感染者脑小血管疾病风险。Objective To analyze the factors affecting the severity grading of white matter hyperintensities(WMH)in the brains of HIV-infected patients.Methods A total of 176 HIV-infected patients diagnosed and underwent brain MRI examination at the Hangzhou Xixi Hospital affiliated to Zhejiang Chinese Medical University from January 2016 to December 2022 were collected and divided into three groups according to different WMH severity grades:129 cases in gradeⅠ,35 cases in gradeⅡ,and 12 cases in gradeⅢ.The distribution of WMH in patients was observed and recorded,and the general clinical data and various laboratory examination data of the three groups of patients were compared to analyze the factors affecting the grading of WMH.Results WMH in most HIV-infected patients were found to coexist in the periventricular and deep brain regions,followed by the deep brain region.The incidence rate of WMH was 88.64%in the deep brain,while 68.75%in the periventricular region.There were statistically significant differences in TG and the duration of combined antiretroviral therapy(cART)treatment among the three groups(both P<0.05).The results of the multifactorial logistic regression analysis showed that the duration of cART treatment(OR=1.007,95%CI:1.000-1.015,P=0.047)was an independent risk factor for the grading of WMH severity in HIV-infected patients.Conclusion WMH is more likely to occur in the deep brain region than in the periventricular region of HIV-infected patients;the duration of cART treatment is an independent risk factor affecting the grading of WMH in HIV-infected patients and may increase the risk of cerebral small vessel disease in HIV-infected patients.

关 键 词：HIV 脑白质高信号 危险因素 联合抗反转录病毒治疗 

分 类 号：R512.91[医药卫生—内科学]