摘要
目的 评价高效抗逆转录病毒治疗（HAART）对HIV感染患者骨密度（BMD）的影响及其相关因素.方法 收集2007-2008年间50例接受HAART的HIV/MDS患者（治疗组）、12例未用HAART的HIV/AIDS患者（未治疗组）、20例健康对照者（对照组）的临床资料,采用双能X线BMD吸收仪（DEXA）测定BMD以及T值,分别对其数据进行统计分析.结果 治疗组中19例（38.0%）患者发生骨量减少,1例（2.0%）患者发生骨质疏松.对照组中5例（25.0%）发生骨量减少,无骨质疏松者.未治疗组中6例（50.0%）患者发生骨量减少,2例（16.7%）患者发生骨质疏松.未治疗组骨量减少/骨质疏松发生率较对照组显著增高（P=0.02）.HIV/AIDS组（包括未治疗组和治疗组）的股骨、股骨颈、大粗隆的BMD[（0.97±0.14）、（0.91±0.13）、（0.76 4-0.12）g/cm2]明显低于对照组[（1.04±0.12）、（0.98±0.14）、（0.84±0.11）g/cm2,P〈0.05];而未治疗组和治疗组的BMD差异无统计学意义.治疗组中,骨量减少/骨质疏松与体重〈60 kg（r=0.074,P=0.004）、使用HAART前血浆病毒载量（r=5.103,P=0.021）呈正相关.结论 未接受HAART的HIV/AIDS患者较健康人骨量减少/骨质疏松发生率高.HIV/MDS患者BMD较健康人低,接受HAART和未接受HAART治疗的HIV/AIDS患者BMD相当.接受HAART患者中,体重〈60 kg、治疗前HIV RNA是发生骨量减少/骨质疏松的危险因素.
Objective To evaluate the influence of highly active antiretroviral therapy （ HAART） on bone mineral density （ BMD ） of human immunodeficiency virus （ HIV） infected patients and correlating clinical factors. Methods The clinical data from 2007 to 2008 were analyzed, including 50 patients treated with HAART （named treated group） ,12 HIV-infected antiretroviral-naive patients （named untreated group） and 20 healthy people （named control group）.Lumbar, femoral neck, femur, femoral greater trochanter and whole body BMD were measured by dual energy X-ray absorptiometry.The data were respectively analyzed.Results There were 19 （38.0% ） patients with osteopenia and 1（2.0% ） patient with osteoporosis in the treated group.There were 6（50.0% ） patients with osteopenia and 2 （16.7% ） patient with osteoporosis in the untreated group.There were 5（25.0% ） patients with osteopenia, no one with osteoporosis in the control group.The prevalence of osteopenia/osteoporosis was statistically higher in the untreated group than that in the control group （P = 0.02）.The BMD of femur, femoral neck and greater trochanter [（0.97±0.14） , （0.91 ±0.13 ） , （0.76 ±0.12） g/cm2] in the HIV-infected group （including the treated and untreated group） were significantly lower than that in the control group [（1.04±.12） , （0.98±.14） , （0.84±0.11） g/cm2 ,P 〈0.05].There were no significantly differences in the BMD between the untreated group and the treated group.In the treated group, osteopenia/osteoporosis correlated with body weight less than 60 kg （r=0.074,P =0.004） and the viral load before HAART（r=5.103,P =0.021）.Conclusions The prevalence of osteopenia and osteoporosis in antiretroviral-naive HIV-infected patients is higher.The BMD of HIV-infected patients are reduced compared with the healthy people.The BMD is similar among HIVinfected patients irrespective of antiretroviral treatment Body weight less than 60 kg and the viral load before HAART are the risk factors of osteopenia/osteoporosis for the HIV-infected antiretroviral patients.
出处
《中华内科杂志》
CAS
CSCD
北大核心
2010年第8期649-652,共4页
Chinese Journal of Internal Medicine
基金
基金项目：＂艾滋病和病毒性肝炎等重大传染病防治＂科技重大专项＂十一五＂计划（2008ZX10001-006）
北京市科技计划课题（D0906003040491）
卫生部临床重点2007-2009
