HAART后高脂血症艾滋病患者生存质量调查及其影响因素分析

The Quality of Life of HIV Infected Individuals with HAART-induced Hyperlipidemia

目的了解北京大学地坛医院教学医院高效抗逆转录病毒治疗(HAART)后所致高脂血症艾滋病患者生存质量以及相关影响因素分析。方法对2014年3月-2014年6月来北京地坛医院就诊的100例HAART后高脂血症艾滋病患者,通过使用中文版世界卫生组织艾滋病生存质量测量简表(WHOQOLHIV-BREF)进行问卷调查,收集患者人口学基本资料与实验室检查结果,计算生存质量总分以及各领域得分,采用单因素及多因素分析影响患者生存质量的因素。结果单因素分析结果提示年龄、婚姻状况、用药方案、HIV确诊时长、腰围、CD4^+T淋巴细胞绝对计数、CD4/CD8比例、HIV-DNA计数、血红蛋白浓度(Hb)、甘油三酯(TC)、总胆固醇(TG)、高密度脂蛋白(HDL)、丙氨酸转移酶(ALT)、空腹血糖(FBG)对患者各领域得分及生存质量总分有一定影响。多元线性回归分析结果提示生理领域得分及社会关系领域得分与FBG水平明显相关(P<0.05);心理领域得分、社会关系领域得分及生存质量总得分与TG水平呈明显的负相关(P<0.05或P<0.01);心理领域得分、独立程度领域得分及环境领域得分与HDL-C水平明显相关(P<0.05或P<0.01);心理领域得分及精神世界领域得分与CD4^+T淋巴细胞计数明显相关(P<0.05);环境领域得分及生存质量总得分与腰围明显相关(P<0.05)。结论对于HAART后高脂血症艾滋病患者,针对上述影响因素进行积极干预,提升患者CD4^+T淋巴细胞计数水平,及时纠正HAART后代谢紊乱,适时提供心理辅导,能有效提高患者生存质量。

Objective To elucidate the quality of life and its related factors in AIDS patients with hyperlipidemia after highly active antiretroviral therapy （HAART） in Beijing Ditan Teaching Hospital, Peking University. Methods Basic demographic data and laboratory test results were collected from 100 cases of AIDS patients with HAART-indueed hyperlipidemia from March 2014 to June 2014 at our hospital. The Chinese version of the World Health Organization Quality of Life Measurement AIDS profile （WHOQOL-HIV-BREF） was used to assess the quality of patients＇ lives. Univariate and multivariate analyses were used to determine the factors affecting the quality of life of patients. Results Univariate analysis showed that the factors impacting total scores of life quality and scores of every domain included age, marital status, therapeutic regimen, duration of HIV diagnosis, waist circumference, absolute CD4^＋ T lymphocyte count, CD4 / CD8 ratio, HIV-DNA count, Hb, TC, TG, HDL, ALT and FBG. Multiple factor linear regression analysis indicated that the score of domains of social relationships and physical domain score were significantly correlated with fasting glucose levels （P 〈 0. 05 ） ; Psychological domain score, score of social relationships and total score of quality of life displayed a negative correlation with triglyceride levels （ P 〈0. 05 or P 〈0. 01 ） ; Psychological domain score, degree of independent domain score, environmental domain score were significantly correlated with high-density lipoprotein （ P 〈 0. 05 or P 〈 0. 01 ） ; Psychological domain and spiritual world domain scores were significantly associated with CD4^＋ T lymphocyte counts （ P 〈 0.05 ） ; Environmental domain and total scores of quality of life were significantly associated with waist circumference （ P 〈 0. 05 ）. Conclusion For AIDS patients with HAART-induced hyperlipidemia, approaches that can effectively improve the quality of patients＇ life include active intervention of the influencing factors, increasing CD4^＋ T cell count, correction of metabolic abnormalities, and timely provision of psychological counseling.