高效抗逆转录病毒治疗艾滋病患者临床毒副作用及疗效动态观察

Observation of Side Effects and Curative Effect in AIDS Patients Treated by HAART

目的了解高效抗逆转录病毒治疗（HAART）临床毒副作用及疗效的动态变化情况。方法分析2011年4-8月昆明市第三人民医院门诊初治艾滋病患者的背景资料、实验室检查、临床毒副作用、治疗方案变更情况。结果共入组73例，16例（21．92％）出现临床毒副作用，29例（39．73％）合并肝炎病毒。最常见的临床毒副作用为骨髓抑制（12．33％），其次为肝毒性（10．96％）、药疹（5．48％）、末梢神经炎（5．48％）、乳酸酸中毒（1．37％，死亡）和脂肪萎缩（1．37％）。随着年龄增大，临床毒副作用发生率越高。CD4’T淋巴细胞数计数分别在0-6月、6-12月和12-24月平均上升94．0cell／μL、44．3cell／μL和34．7cell／μL。静脉吸毒的艾滋病患者治疗后CD4^＋T淋巴细胞计数上升幅度小于其他传播途径的患者。结论接受HAART治疗的艾滋病患者临床毒副作用发生率高，是导致患者死亡的重要原因．需密切监测。

Objective To understand dynamic variation of side effects and curative effect among AIDS patients trea- ted by highly active antiretroviral therapy （HAART）. Methods All AIDS patients visited the Outpatient Clinic, the Third People＇ s Hospital of Kunming from April 2011 to August 2011 were analyzed, including background information, laboratory tests, side effects, alteration of therapeutic regimen. Results Seventy three AIDS patients were enrolled. Amongst them, 16 （21.92%）patients had side effects and 29 （39.73%） patients were co-infected with hepatitis virus. The most common side effect was myelosuppression （ 12. 33% ）, followed by live damage （ 10. 96% ）, drug eruption （5.48%）, peripheral neuritis （5.48%）, lactic acidosis （1.37% ,death）and lipoatrophy （1.37%）. With age increasing, the incidence of side effect was higher. The CD4^＋T lymphocyte counts had respectively increased to 94cell/μL, 44. 3cell/μL and 34. 7cell/μL during 0 to 6 months, 6 to 12 months and 12 to 24 months, respectively. The CD4 ^＋ T lympho- cyte counts of AIDS patients infected by intravenous drug user had less increase than others. Conclusion Clinical side effect was frequent among AIDS patients treated by HAART. These are important causes of death and should be monitored closely.