拉米夫定、替诺福韦、洛匹那韦利托那韦联合治疗对HIV/AIDS患者细胞免疫及病毒载量变化分析  

Analysis of Changes in Cellular Immunity and Viral Load in HIV/AIDS Patients Treated with Lamivudine,Tenofovir,and Lopinavir Ritonavir in Combination

作　　者：卢志钢 邱国兵 程如虹 LU Zhigang;QIU Guobing;CHENG Ruhong(Leping People's Hospital,Jingdezhen Jiangxi 333300,China.)

机构地区：[1]乐平市人民医院,江西景德镇333300

出　　处：《药品评价》2024年第7期846-850,共5页Drug Evaluation

摘　　要：目的分析拉米夫定、替诺福韦、洛匹那韦利托那韦联合对人类免疫缺陷病毒/获得性免疫缺陷综合征(HIV/AIDS)患者细胞免疫及病毒载量变化。方法选取2020年1月至2023年3月期间在乐平市人民医院诊断为HIV/AIDS的84例患者作为此次试验的研究对象,按照治疗方法将其分为对照组(n=35)和观察组(n=49),其中对照组采用拉米夫定、替诺福韦、依非韦伦联合治疗,观察组采用拉米夫定、替诺福韦、洛匹那韦利托那韦联合治疗。比较两组治疗前后细胞免疫(CD3^(+)、CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+))水平,生化指标[谷丙氨酸转移酶(ALT)、谷草氨酸转移酶(AST)、血肌酐(Cr)、胆固醇(TC)、甘油三酯(TG)]水平,病毒载量,不良反应发生率。结果治疗1个月时,两组CD3^(+)和CD8^(+)均较治疗前下降(P<0.05),且观察组低于对照组(P<0.05),两组CD4^(+)和CD4^(+)/CD8^(+)均治疗前上升(P<0.05),且观察组高于对照组(P<0.05);治疗3个月时,两组CD3^(+)和CD8^(+)均较1个月时下降(P<0.05),且观察组低于对照组(P<0.05),两组CD4^(+)和CD4^(+)/CD8^(+)均较1个月时上升(P<0.05),且观察组高于对照组(P<0.05)。治疗前,两组ALT、AST、Cr、TC、TG等均差异无统计学意义(P>0.05),治疗后,ALT、AST、Cr、TC、TG均较治疗前上升,观察组高于对照组(P<0.05),且ALT、AST、Cr、TC均在正常范围内,治疗3个月时,TG已高于正常范围。治疗1个月时,两组的病毒载量较治疗前下降,但差异无统计学意义(P>0.05),治疗3个月时,两组的病毒载量均较治疗1个月时下降(P<0.05),且观察组低于对照组(P<0.05)。治疗期间,两组腹泻、恶心呕吐、胸闷、皮疹的发生率均差异无统计学意义(P>0.05),且总发生率差异无统计学意义(P>0.05)。结论HIV/AIDS患者采用拉米夫定、替诺福韦、洛匹那韦利托那韦联合治疗后,可改善患者的细胞免疫水平,并有效降低细胞载量,且具有一定安全性,对临床治疗AIDS具有重要的参考Objective To analyze the effects of combination therapy with lamivudine,tenofovir,and lopinavir ritonavir on cellular immunity and viral load in patients with human immunodeficiency virus/acquired immunodeficiency syndrome(HIV/AIDS).Methods A retrospective study was conducted on 84 HIV/AIDS patients who visited Leping People's Hospital from January 2020 to March 2023.They were divided into a control group(n=35)and an observation group(n=49)according to the treatment method.The control group was treated with a combination of lamivudine,tenofovir,and efavirenz,while the observation group was treated with a combination of lamivudine,tenofovir,and lopinavir ritonavir.The two groups were compared before and after treatment in cellular immunity(CD3^(+),CD4^(+),CD8^(+),CD4^(+)/CD8^(+)),the biochemical indicators of alanine transferase(ALT),alanine transferase(AST),creatinine(Cr),cholesterol(TC),and triglycerides(TG),viral load,and compare the incidence of adverse reactions between the two groups of patients.Results At the end of one month treatment,the levels of CD3^(+)and CD8^(+)in both groups decreased compared to before treatment(P<0.05),the observation group was lower(P<0.05),the levels of CD4^(+)and CD4^(+)/CD8^(+)in both groups were increased before treatment(P<0.05),and the observation group was higher(P<0.05);at the end of three months treatment,the levels of CD3^(+)and CD8^(+)in both groups were decreased compared to one month(P<0.05),and the observation group was lower(P<0.05),both groups showed a increase in CD4^(+)and CD4^(+)/CD8^(+)at 1 month(P<0.05),the observation group was higher(P<0.05).Before treatment,there was no significant difference in ALT,AST,Cr,TC,TG between the two groups(P>0.05);after treatment,ALT,AST,Cr,TC,TG were increased compared to before treatment,and the observation group was higher(P<0.05);ALT,AST,Cr,TC were all within the normal range,and TG was already above the normal range after 3 months of treatment.At one month of treatment,the viral load of both groups decreased compared to bef

关 键 词：拉米夫定 替诺福韦 洛匹那韦利托那韦 细胞免疫 病毒载量 

分 类 号：R512.91[医药卫生—内科学]