人免疫缺陷病毒感染/获得性免疫缺陷综合征患者在联合抗反转录病毒治疗中静息心率和QTc间期变化的研究

Changes of resting heart rate and QTc interval in processes of combined antiretroviral therapy in human immunodeficiency virus infected/acquired immune deficiency syndrome patients

目的探讨人免疫缺陷病毒(HIV)感染/获得性免疫缺陷综合征(AIDS)患者(PLWHA)在联合抗反转录病毒治疗(cART)中静息心率和QTc间期的变化。方法根据CD4+T淋巴细胞计数,将110例初发、规律进行cART的PLWHA分为HIV感染组(82例)和AIDS组28例。两组患者均采用替诺福韦(TDF)、拉米夫定(3TC)联合依非韦伦(EFV)方案进行cART。比较两组患者治疗前、治疗1、3、6、12个月时静息心率及QTc间期的变化。结果HIV感染组患者治疗前后各时间点静息心率比较差异均无统计学意义(P>0.05)。AIDS组患者治疗6、12个月时静息心率低于同组治疗前(P<0.05)。HIV感染组患者治疗前、治疗1、3个月时静息心率均低于AIDS组同一时间(P<0.05)。HIV感染组患者治疗3个月时QTc间期长于同组治疗前(P<0.05)。治疗前AIDS组患者QTc间期长于HIV感染组(P<0.05)。结论cART前AIDS患者的静息心率高于HIV感染患者,QTc间期长于HIV感染患者。cART 3个月时HIV感染患者的QTc间期较治疗前延长。

Objective To analyze the changes of resting heart rate and QTc interval in processes of combined antiretroviral therapy(cART)in human immunodeficiency virus(HIV)infected/acquired immune deficiency syndrome(AIDS)patients(PLWHA).Methods According to CD4+lymphocyte count,110 PLWHA who were newly diagnosed and treated with cART regularly were divided into HIV infected group(82 cases)and AIDS group(28 cases).Patients in the two groups were all treated with tenofovir(TDF),lamivudine(3TC)combined with efavirenz(EFV)regimen for cART.Changs of resting heart rate and QTc interval between patients of HIV infected group and AIDS group before treatment,at 1,3,6,12 months of treatment were compared.Results There were no significant differences of resting heart rate at each time point before and after treatment in patients of HIV infected group(P>0.05).Resting heart rate at 6 and 12 months of treatment was significantly lower than that before treatment in patients of AIDS group(P<0.05).Resting heart rate of patients in HIV infected group before treatment,at 1 and 3 months of treatment were all lower than those at the same time of patients in AIDS group(P<0.05).QTc interval at 3 months of treatment was significantly higher than that before treatment in patients of HIV infected group(P<0.05).QTc interval of patients in AIDS group was longer than that in HIV infected group before treatment(P<0.05).Conclusion Resting heart rate of AIDS patients is higher and QTc interval is longer than those of HIV infected patients before cART.QTc interval of HIV infected patients at 3 months of cART is longer than that before treatment.