艾滋病病人接受抗病毒治疗后入院情况分析

Hospitalization following antiretroviral therapy for AIDS patients

目的分析艾滋病(AIDS)病人接受抗反转录病毒治疗后(ART)入院的常见原因。方法回顾性分析2005年1月至2009年2月,接受ART治疗后住院的艾滋病病例的临床资料。结果接受ART治疗的艾滋病住院病人共300人次,其中41.00%(123/300)、21.67%(65/300)、18.00%(54/300)和19.33%(58/300)的病人,分别在接受抗病毒治疗后半年内、半年到1年之间、1-2年间和治疗2年后入院。CD4细胞计数<200的病人占入院人数的80.14%(109/136),>200的占19.86%(27/136)。ART治疗半年内住院的原因,主要是ART的不良反应,占59.55%(53/89);治疗2年后住院的原因,机会性感染占20.68%(12/58)。单次入院的主要原因为:细菌、真菌感染占20.22%(18/89),药物性肝损13.48%(12/89),结核病8.99%(8/89)。多次入院的主要原因为:隐球菌脑膜炎复查28.91%(61/211),肿瘤化疗19.43%(41/211),结核病9.95%(21/211)。结论抗病毒药物的不良反应和机会性感染或肿瘤,是接受抗病毒治疗后病人入院的主要原因。降低药物不良反应,提高病人依从性,尽快重建机体的免疫功能,是减少病人入院的关键所在。

Objective To analyze the reason why AIDS patients are hospitalized following antiretroviral therapy. Methods Patients＇ data hospitalized in Shanghai Public Health Clinical Center from January 2005 to February 2009 were analyzed retrospectively. Results A total of 300 clinical cases were collected,and the percentage of hospitalization after receiving antiretroviral therapy for 6 moths,6-12 months,12-24 month,and over 24 months were 41.00%（123/300）,21.67%（65/300）,18.00%（54/300）and 19.33% （58/300）,respectively.There were 80.14%（109/136）of patients whose baseline CD4 200,and 19.86%（27/136） whose baseline CD4200. Of the patients 59.55%（53/89） were hospitalized in 6 months following ART due to adverse reactions; 20.22% （18/89） were hospitalized in 2 year following ART due to infection; 13.48%（12/89） due to drug induced liver damage and 8.99%（8/89） due to tuberculosis infection. The major reason for patients ＇re-hospitalization were Cryptococcus meningitidis-28.91% （61/211）,tumor-19.43% （41/211） and tuberculosis-9.95% （21/211）. Conclusions The adverse reactions of antiretroviral drugs and opportunistic Infections or tumor are the major reasons for hospitalization among patients after receiving ART. The key to reducing patients＇ hospitalization is to lower the adverse reactions of ARV drugs and improve patients＇ adherence in order to reconstitute their immunity as soon as possible.