克力芝对成人HIV/AIDS病人血脂影响的临床分析

Clinical analysis of impact of Kaletra on blood lipids in adult HIV/AIDS patients

目的了解蛋白酶抑制剂克力芝(LPV/r)对艾滋病病毒(HIV)感染者/艾滋病(AIDS)病人(简称HIV/AIDS病人)血脂代谢的影响。方法对2012年1-12月86例接受克力芝治疗的HIV/AIDS病人进行前瞻性研究,观察克力芝治疗前(基线)及治疗后1、3、6、9、12个月,血清胆固醇(TC)、甘油三酯(TG)及低密度脂蛋白(LDL)水平,比较治疗前后血脂的变化。结果 86例病人中男性61例,女性25例,使用克力芝前均接受过1个月至8年的高效抗反转录病毒治疗(HAART)。基线血清TC、TG及LDL升高者的比例分别为14.29%、65.06%、25.30%,经克力芝治疗后,血清TC、TG及LDL升高者的比例分别为33.78%、90.79%、60.00%,均较基线增多,差异有统计学意义(P均<0.05)。血清TCHOL一般于治疗后1-8个月开始升高,中位时间2个月;血清TG一般于治疗后1-8个月升高,中位时间1.5个月;血清LDL一般于治疗后1-10个月升高,中位时间2个月;治疗后高峰时间均为1-12个月,中位时间为3个月。结论克力芝可明显升高HIV/AIDS病人的血脂水平,应定期监测,必要时加以干预。

Objective To study the effect of the protease inhibitor Kaletra （LPV/r） on the metabolism of lipids in adult HIV/AIDS patients. Methods A prospective study was conducted in 86 adult HIV/AIDS patients receiving Kaletra containing regimen in our clinic from Junuary 2012 to December 2012. The results of total cholesterol （TCHOL）, triglyceride （TG） and low-density lipoprotein （LDL） were collected at baseline and 1, 3, 6, 9, and 12 months after Kaletra based highly active antiretroviraI therapy （HAART）. Lipid profiles were compared before and after ART. Result Of the 86 patients, 61 were male and 25 were female. They had all received 1-8 months of ART before taking Kaletra. The proportions of TCHOL, TG and LDL elevation at baseline were 14.29o//0, 65. 060//oo and 25.30~, respectively. After treatment with Kaletra, they increased to 33.78%, 90.79~ and 60.00%, respective ly, with significant difference compaired with those at baseline （P^0.05）. The elevation of serum TCHOL and TG usually occured at 1 to 8 months after Kaletra therapy, with the median of 2 months for TCHOL and 1.5 months for TG. The elevation of LDL occured at 1 to 10 months, with the median time of 2 months. Peak times of the 3 pa- rameters were all 1 to 12 months, with the median peak time of three months. Conclusions Kaletra can significantly increase blood lipid in adult HIV/AIDS patients. Blood lipid should be monitored regularly and intervened necessarily.