HIV/AIDS病人血脂及C-反应蛋白的研究

A study on lipids and C-reactive protein in HIV-infected patients

目的研究艾滋病病毒（HIV）感染者/艾滋病（AIDS）病人（简称HIV/AIDS病人）血脂及C-反应蛋白（CRP）的水平,以探讨HIV/AIDS病人体内这些因子是否与CD4＋T细胞数及高效抗反转录病毒治疗（HAART）相关。方法选取2005年1月至2009年12月,在上海市公共卫生临床中心就诊的HIV/AIDS病人348例,流式细胞仪检测CD4＋T细胞数,采用全自动生化分析仪测定血脂含量,免疫分析仪测定血清CRP含量。统计分析血脂及CRP与CD4＋T细胞数及HAART的关系。结果入选的348例HIV/AIDS病人CD4＋T细胞数为47（14~165）个/μl,72例（20.7%）已经开始HAART,HAART时间为6（1-15.75）个月。HAART治疗组与未治疗组病人相比具有较高浓度的总胆固醇、高密度脂蛋白（HDL）和载脂蛋白（Apo）A1,P值分别为：0.0288、0.0004、0.0052。272例（78.2%）CD4＋T细胞数≤200/μl病人与76例（21.8%）〉200个/μl的病人相比,具有较低浓度的总胆固醇、高密度脂蛋白（HDL）、载脂蛋白（Apo）A1高浓度CRP,P值分别为：0.0015、0.0000、0.0000、0.0156。多重线性回归分析将年龄、性别、吸烟因素调整后,表明HAART治疗同HDL（β=0.1476,P=0.004）、Apo-A1（β=0.1341,P=0.007）具有独立相关关系,CD4＋T细胞数的变化同总胆固醇、HDL、LDL、Apo-A1、Apo-B具有独立相关关系。结论 HIV/AIDS病人CD4＋T细胞数及开始HAART治疗同血脂及CRP浓度密切相关,HAART治疗有利于提高HDL、Apo-A1的水平。

Objective To investigate serum lipids and C-reactive protein（CRP） and explore whether these factors are related with CD＋4T cells and HAART.Methods Venous blood samples were collected from 348 HIV patients from January 2005 to December 2009 in our center.The CD＋4T cells were determined by flow cytometry.serum lipids were assayed by automatic biochemistry analyzer and CRP was assayed by immune analyzer.Stata7.0 was used to analyze data obtained.Results The median absolute CD＋4T count was 47（14-165）/μl in 348 cases.Seventy two（20.7%） patients were treated with antiretroviral drugs and the median length was 6（1-15.75）months.ARV-treated patients,as compared with ARV-naive patients,had higher total cholesterol（P=0.0288）,HDL（P=0.0004）,Apo A1（P=0.0052）;272（78.2%） patients with CD＋4T count ≤200/μl,as compared with 76（21.8%） with CD＋4T count 200/μl,had lower total cholesterol（P=0.0018）,HDL（P=0.0000）,Apo A1（P=0.0000）,higher CRP（P=0.0004）.Multiple linear regression analysis showed that current antiretroviral therapy was independent factors associated with HDL（β=0.1476,P=0.004） and Apo A1（β=0.1341,P=0.007） levels,CD＋4T cells were independent factors associated with total cholesterol,HDL,LDL,Apo A1 and Apo B levels,adjusting for age,sex and cigarette smoking in these patients.Conclusion The CD＋4T cells and antiretroviral therapy were closely related with serum lipids and CRP levels.HAART may improve HDL and Apo A1 levels.