摘要
目的对上海市39例血友病A合并艾滋病（血友病／艾滋病）患者高效抗逆转录病毒治疗（HAART）6年后予以临床回顾。评价在血友病／艾滋病患者当中，HAART治疗对其出血状况、关节功能和体能状况的影响；同时观察HAART治疗对患者HIV病毒复制的控制及促进CD；T细胞恢复的效果。方法收集2002-2008年间39例血友病／艾滋病患者的临床资料，对其HAART治疗6年前后的平均门诊次数（次／年）、平均出血次数（7欠／年）、平均Ⅷ因子输注次数（次／年）、平均Ⅷ因子使用总量（IU／年）以及Ⅷ：C活性指标进行分析；同时观察患者外周血血常规、CD；T细胞计数和HIV病毒载量的改变；采用计量表的方式进一步对患者体能状况和关节功能进行评分和比对。结果39例患者HAART治疗前后平均门诊次数、平均出血次数、平均Ⅷ因子输注次数和平均使用Ⅷ因子总量组间比较差异无统计学意义（P〉0．05）；39例患者中仅1例出现Ⅷ：C活性由1％～5％以降至〈1％，1例患者体能和关节功能有所减弱，其余未发生改变；HAART治疗前后，血红蛋白（Hb），白细胞（WBC）、血小板计数（PLT）差异无统计学意义（P〉0．05）。治疗前HIVRNA为（4．8±1．0）log拷贝／ml，治疗6年后为（2．4±1．0）log拷贝／m｜（P〈0．05）；CD4T细胞计数：治疗前平均为（183±97）个／mm^3，治疗6年后平均为（456±157）个／mm^3（P〈0．05）。结论HAART治疗对血友病／艾滋病患者出血状况、关节功能和体能无明显影响；HAART治疗对于在血友病／艾滋病患者中控制HIV复制及CD4^＋T细胞恢复是有效的。
Objective To evaluate the impact of highly active antiretroviral therapy （HAART） on the haemorrhage status, joint function, and physical ability of the patients of hemophilia combined with acquired immunodeficiency syndrome （ AIDS ）. Methods Thirty-nine hemophilia A/AIDS patients, all male, aged （40 ± 13 ）, underwent HAART and followed up for 6 years from 2002 to 2008 to observe the yearly hospital visit time, bleeding time, transfusion times, amount of factor wm transfusion, Ⅷ ： C level, physical ability, and joint function. Flow cytometry was used to count the CD; T cells, and bDNA assay was used to examine the HIV virus load. Results The average hospital visit time, bleeding time, transfusion time, and amount of factorⅧ transfusion, hemoglobin, white blood cell count, and platelet count before HAART were not significantly different from those after treatment （ all P 〉 0. 05 ） ; only one case showed moderate decrease in Ⅷ：C level, and another one case showed slight decline in physical ability and joint function. The serum HIV RNA load decreased from （4.8 ± 1.0） log copies/ml before HAART to （2.4 ± 1.0） log copies/ml （P 〈 0.05 ） and the C D; T cell count raised from 183±97/mm^3 to 456± 157/mm^3 （P 〈0. 05） after HAART. Conclusion HAART has no obvious impact on the haemorrhage status, joint function, and physical ability in hemophilia A/AIDS patients, however, it is effective to inhibit HIV replication and raise CD4^＋ T cell number which indicates that HAART therapy is positive for immune recovery.
出处
《中华医学杂志》
CAS
CSCD
北大核心
2009年第13期872-875,共4页
National Medical Journal of China
