人类免疫缺陷病毒感染与臂间血压差异相关性研究

Human immunodeficiency virus infection and inter-arm blood pressure difference

目的分析人类免疫缺陷病毒(HIV)感染的患者心血管危险因素与臂间血压差异(IAD)的相关关系,明确HIV感染是否有促进动脉粥样硬化的作用。方法采用病例对照研究的方法,比较分析2007—2008年北京协和医院41例未经高效抗逆转录病毒联合疗法(HAART)治疗的HIV患者与43例普通对照人群的传统心血管危险因素和IAD,并进一步分析IAD与HIV感染指标的相关性。结果未经HAART治疗的HIV患者的总胆固醇、低密度脂蛋白胆固醇及高密度脂蛋白胆固醇则均低于对照组(P<0.01)。HIV组患者的臂间收缩压差异(sIAD)和臂间舒张压差异(dIAD)均明显大于对照组[sIAD:(6.22±4.64)mmHg对(2.98±2.69)mmHg,P<0.01;dIAD:(4.20±2.93)mmHg对(2.23±3.17)mmHg,P<0.01](1 mmHg=0.133 kPa)。sIAD与病毒载量的对数成负相关(r=-0.370,P=0.02);而dIAD与HIV感染指标没有明显相关性(P>0.05)。结论即使是未经过HAART治疗的HIV患者,与普通人群相比,仍存在有早发动脉粥样硬化的趋势,因此HIV感染本身可能促进动脉粥样硬化。

Objective To analyze the association between cardiovascular risk factors and inter-arm blood pressure difference （IAD） in patients with human immunodeficiency virus （HIV） infection, and to confirm as to whether HIV infection promotes atherosclerosis. Methods 41 HAART-naive HIV infected-patients and 43 healthy people were analyzed and compared their conventional cardiovascular risk factors and IAD by cross-sectional study. And the association between IAD and HIV infection was further analyzed. Results Compared with control group, infected patients without HAART-treatment had lower total cholesterol,low density lipoprotein cholesterol and high density lipoprotein （P 〈 0. 01 ）. The sIAD and dIAD in HIV group were significantly higher than those in control group [ sIAD： （6. 22 ±4. 64 ）mmHg vs （2.98 ±2. 69 ）mmHg, P 〈 0. 01 ;dIAD： （4. 20 ±2. 93）mmHg vs （2. 23 ±3. 17）mmHg,P 〈0. 01 ]. The association analysis demonstrated the negative correlation between sIAD and logarithm of virus load （ related coefficient = - 0. 370, P = 0. 02 ） but no significant correlation between dIAD and HIV infection index （ P 〉 0. 05 ）. Conclusion Compared with the normal healthy people, even HIV infected patients without HAART treatment remained the trend of early atherosclerosis development.