摘要
目的探讨艾滋病病毒感染(HIV/AIDS)者在抗逆转录病毒治疗(antiretroviral therapy,ART)过程中高三酰甘油血症(三酰甘油≥2.3 mmol/L)、高胆固醇血症(总胆固醇≥6.2 mmol/L)、高血糖(空腹血糖≥6.10 mmol/L)的发生情况及其可能影响因素。方法采用回顾性队列研究,收集广州市某传染病专科医院2004-2019年期间首次接受ART的HIV/AIDS患者基线和随访数据。采用多因素Cox比例风险回归模型分析高三酰甘油血症、高胆固醇血症、高血糖发生的可能影响因素。结果HIV/AIDS患者8839例。在ART过程中,新发高三酰甘油血症4255例(48.14%),高胆固醇症1234例(13.96%),高血糖2647名(29.95%),总发病密度分别为28.12/100人年、5.11/100人年和14.22/100人年。多因素Cox比例风险回归模型结果显示,基线BMI、开始ART年份、基线WHO临床分期、基线机会性感染、临床症状种类数、初始ART方案、基线CD4细胞计数与高三酰甘油血症的发生有关;性别、年龄、基线BMI、开始ART年份、基线WHO临床分期、基线机会性感染、初始ART方案、基线CD4细胞计数与高胆固醇症的发生有关;性别、年龄、基线BMI、开始ART年份、感染途径、基线机会性感染、基线CD4细胞计数与高血糖的发生有关。结论HIV/AIDS患者ART过程中易发生高三酰甘油血症、高胆固醇血症、高血糖,应动态监测患者的血脂、血糖情况,尤其是对采用含克力芝方案治疗的患者,以期对高风险患者及时进行早期干预,调整治疗方案,预防心血管疾病等慢性非传染性疾病的发生,提高患者生命质量。
Objective To study the incidence and factors associated with hypertriglyceridemia(triglyceride≥2.3 mmol/L),hypercholesterolemia(total cholesterol≥6.2 mmol/L),and hyperglycemia(fasting plasma glucose≥6.10 mmol/L)in people living with HIV/AIDS(PLWHA)during antiretroviral therapy(ART).Methods A retrospective cohort study was conducted,which collected baseline and follow-up data from PLWHA who received ART for the first time from 2004 to 2019 in the largest infectious diseases hospital in Guangdong Province.The Cox proportional hazard model was used to explore the factors influencing the incidence of hypertriglyceridemia,hypercholesterolemia,and hyperglycemia in the PLWHA.Results There were 8839 PLWHA.During ART,hypertriglyceridemia,hypercholesterolemia,and hyperglycemia were present in 4255(48.14%),1234(13.96%),and 2647(29.95%)cases of PLWHA,with a total incidence density of 28.12 per 100 person-years,5.11 per 100 person-years,and 14.22 per 100 person-years,respectively.The results of the Cox proportional hazard model showed that the body mass index(BMI),the year of ART initiation,the baseline WHO clinical stage,the baseline opportunistic infections,the number of clinical symptom categories,initial ART regimen,and the baseline CD4+T cell count were associated with the incidence of hypertriglyceridemia in the PLWHA.The gender,age,the baseline BMI,the year of ART initiation,the baseline WHO clinical stage,the baseline opportunistic infections,the initial ART regimen,and the baseline CD4+T cell count were associated with the incidence of hypercholesterolemia in the PLWHA.The gender,age,the baseline BMI,the year of ART initiation,the route of infection,the baseline opportunistic infections,and the baseline CD4+T cell count were associated with the incidence of hyperglycemia in the PLWHA.Conclusion PLWHA after ART are prone to have hypertriglyceridemia,hypercholesterolemia,and hyperglycemia.It is important to dynamically monitor the levels of blood lipid and blood glucose in PLWHA,especially for patients receiving therapy of lopinavir/ritonavir oral solution(LPV/r).Early intervention should be provided to high-risk patients by adjusting the treatment regimen to prevent the incidence of non-AIDS-defining diseases,such as cardiovascular diseases,and improve the quality of life for patients.
作者
林婧
邱园园
李粤平
李燕秋
冯立慧
欧峻祺
周馨
郜艳晖
李丽霞
贾卫东
LIN Jing;QIU Yuanyuan;LI Yueping;LI Yanqiu;FENG Lihui;OU Junqi;ZHOU Xin;GAO Yanhui;LI Lixia;JIA Weidong(School of Public Health,Guangdong Pharmaceutical University,Guangzhou 510310,China;Infection ICU,the Eighth Affiliated Hospital of Guangzhou Medical University,Guangzhou 510060,China;School of Basic Medicine and Public Health,Jinan University,Guangzhou 510632,China)
出处
《广东药科大学学报》
CAS
2024年第4期130-138,共9页
Journal of Guangdong Pharmaceutical University
基金
国家科技重大专项(2017ZX10202101-004-009)
广州市科技计划项目(202206010009)。
