摘要
目的:使用高效抗反转录病毒药物治疗(highly active antiretroviral therapy,HAART)50例血友病合并艾滋病和丙型肝炎的患者,观察长期疗效和副作用,了解血淋巴细胞绝对计数(TLC)和β2-微球蛋白(β2-MG)在HAART疗效判断中的作用。方法:用反转录病毒药物治疗CD4+T淋巴细胞计数≤200/mm3的50例血友病合并艾滋病和丙型肝炎患者,定期检查其CD4+T淋巴细胞计数、HIV病毒载量(HIVRNA)、血红蛋白(Hb)、血白细胞(WBC)、血红细胞(RBC)、血总胆红素(SB)、血谷丙转氨酶(ALT)等,同时配对分析TLC与CD4+淋巴细胞计数、血β2-MG与HIVRNA的相关性。结果:在HAART治疗2~6个月后,50例患者血浆病毒载量均低于50copies/ml(P<0.0001),CD4+T淋巴细胞平均上升了257/mm3(P<0.001)。血TLC与CD4+T淋巴细胞计数存在一定相关性,r=0.46,P<0.01。血β2-MG与HIVRNA水平未见有相关性(r=0.22,P>0.05)。结论:HAART能快速抑制HIVRNA的复制和重建免疫功能,施多宁、赛瑞特和拉米夫定联合治疗方案安全、高效;血TLC和β2-MG检测可为资源贫乏地区的抗病毒治疗提供临床参考。
Objective To study their long-term therapeutic effect and adverse reaction of highly active antiretroviral therapy in 50 hemophilia patients co-infected AIDS/HCV. To know about their clinical significance and correlation of lymphocyte absolute count, β2-microglobulin assay and HIV RNA level in these patients. Methods All patients have been received active antiretroviral therapy when their CD4^+T lymphocyte count is less than 200/mm^3. Every patient blood sample have been taken to test their CD4^+T lymphocyte count,HIV virus load,heamoglobin,white blood cell ,red blood cell,total bilirubin ,alanine aminotransferase (ALT)etc periodically. To study their correlation by matched-pairs analysis among these tests of lymph cell absolute count, CD4^+T lymphocyte count, β2-microglobulin and HIV virus load. Results All patients have received active antiretroviral therapy from two to six months, their HIV virus load in blood plasma are less than 50 copies/ml(P〈0.0001 ) and CD4^+T lymphocyte count has risen for average 257/mm^3(p〈0.001). Lymphocyte absolute count is correlated with CD4^+T lymphocyte count in these patients, r=0.46 ,P〈0.01. There is no relation between β2-microglobulin assay and HIV viral load. r=-0,22,P 〉0.05. Conclusions During the HAART treatment period, patients' HIV viral load can be suppressed quickly and their immunological function can be reconstituted. Combined treatment of Efavirenze, Stavudine and Lamifudine is safe and highly effective, Lymphocyte absolute count and β2-microglobulin assay are useful for long-term monitoring and clinical observation in the limited resource area.
出处
《诊断学理论与实践》
2007年第3期192-196,共5页
Journal of Diagnostics Concepts & Practice