摘要
目的分析深圳市人类免疫缺陷病毒(HIV)-1感染未治疗人群神经认知功能损伤的特点及影响因素,为医疗卫生人员早期干预提供科学依据。方法采用蒙特利尔认知评估(MoCA)量表北京版和自制调查问卷,结合临床和实验室血清学指标,对深圳HIV-1感染未治疗人群进行立意抽样横断面研究调查。结果在全部171例HIV-1感染未治疗者中,MoCA测试得分<26分,怀疑存在神经认知功能损害者占46.78%(80/171);该人群中MoCA<26分认知功能损伤组与得分正常组相比主要在视结构技能、执行能力、命名、延迟回忆、注意与集中、语言、抽象思维项目方面分值下降较多,差异有统计学意义(P均<0.05)。在该人群中,不同CD4+T淋巴细胞计数段中发生HIV相关神经认知功能障碍(HAND)的危险性差异无统计学意义(P=0.44),但年龄和受教育年限对神经认知功能有显著影响,年龄为危险因素,受教育年限为保护因素。结论深圳市HIV-1感染未治疗人群发生HAND的危险性较高,常见视结构技能、执行能力、命名、延迟回忆、注意与集中、语言、抽象思维等方面认知功能受损,且年龄越大、受教育程度越低越容易发生,医务工作者应对此予以足够重视,及早发现和干预,延缓认知功能受损速度。
Objective To analyze the characteristics and influencing factors of HIV-1 associated neurocognitive disorders(HAND)in treatment-naive HIV-1 infected patients in Shenzhen,and provide a scientific basis for early intervention formedical staff. Methods The Montreal cognitive assessment scale Beijing edition and self-made questionnaire wereadministered for a cross-sectional survey,combined with clinical and laboratory serological indexes in treatment na?ve HIV-1 infected participants. Results Suspected neurocognitive impairment accounted for 46.78% in all 171 cases of treatmentna?ve HIV-1 infected participants. Compared with normal functioning group in treatment na?ve HIV-1 infected participants,the cores decreased more in the structure of skills,executive ability,naming,delayed recall,language and concentration,attention,abstract thinking in neurocognitive impairment group. Among treatment na?ve HIV-1 infected participants,therisk of HAND in different CD4^+T lymphocyte count showed no significant difference,while age and education year hadsignificant effects on the neurocognitive function. Age was risk factor and education year was protective factor. Conclusion Therisk of HAND was relatively high in treatment na?ve HIV-1 infected patiens in Shenzhen;cognitive impairments such asstructural skills,executive ability,naming,delayed recall,attention and concentration,language,abstract thinking wereimpaired;the older the patient and the lower the level of education,the more likely was to develop neurocognitive disorders.Medical workers should pay more attention for early detection and intervention on these HAND high-risk groups,in order toslow the speed of cognitive function impairment.
作者
杨馨
刘丹
张文锋
奉水东
赵锦
赵方
杨峥嵘
YANG Xin;LIU Dan;ZHANG Wen-feng;FENG Shui-dong;ZHAO Jin;ZHAO Fang;YANG Zheng-rong(School of Public Health, South China University, Hengyang, Hunan 421000;Department of AIDS Control and Prevention, Shenzhen Center for Disease Control and Prevention, Shenzhen, Guangdong 518000;The Third People's Hospital in Shenzhen , Shenzhen , Guangdong 518000, China)
出处
《热带医学杂志》
CAS
2018年第5期569-573,共5页
Journal of Tropical Medicine
基金
深圳市基础研究学科布局项目(JCYJ20160331173336891)
关键词
人类免疫缺陷病毒
神经认知功能
蒙特利尔认知评估量表
横断面调查
Human immunodeficiency virus
Neurocognitive ruction
The Montreal cognitive assessment scale
Crosssectional survey