比较不同抗逆转录病毒治疗方案对老年HIV感染者血脂水平的影响

Comparison of the effect of different antiretroviral therapy regimen on blood lipids level in elderly patients with human immunodeficiency virus

目的对比不同抗逆转录病毒治疗(ART)方案对老年人类免疫缺陷病毒(HIV)感染者血脂水平的影响。方法选取2019年4月至2021年4月新疆医科大学第八附属医院诊治的104例老年HIV感染者作为研究对象。随机分为非核苷类逆转录酶抑制剂(NNRTI)组和蛋白酶抑制剂(PI)组。检测两组治疗前与治疗后血清甘油三酯(TG)、总胆固醇(TC)、高密度脂蛋白(HDL)、低密度脂蛋白(LDL)及载脂蛋白(Apo)水平。比较两组治疗效果、高脂血症发生率及并发症发生率。结果治疗后,两组TC、TG、ApoB、ApoCⅢ和ApoE水平均显著升高,HDL、ApoA水平均显著降低(P<0.05),且PI组TG、ApoCⅢ和ApoE水平显著高于NNRTI组,HDL、ApoA水平显著低于NNRTI组(P<0.05);治疗后,PI组高脂血症总发生率高于NNRTI组(P<0.05);NNRTI组神经精神症状发生率及不良反应总发生率高于PI组(P<0.05)。结论接受PI的老年HIV感染者更容易出现血脂异常及高脂血症。

Objective To compare the effects of different antiretroviral therapy(ART)on blood lipid levels in elderly patients with human immunodeficiency virus(HIV)infection.Methods A total of 104 elderly patients with HIV infection in the Eighth Affiliated Hospital of Xinjiang Medical University from April 2019 to April 2021 were selected as research subjects and randomly divided into non⁃nucleoside reverse transcriptase inhibitor(NNRTI)group and protease inhibitor(PI)group.The levels of serum triglyceride(TG),total cholesterol(TC),high density lipoprotein(HDL),low density lipoprotein(LDL)and apolipoprotein(Apo)were measured before and after ART.The therapeutic effect,incidence of hyperlipidemia and complications were compared between the two groups.Results The levels of TC,TG,ApoB,ApoCⅢand ApoE were significantly increased and the levels of HDL and ApoA were significantly decreased in both groups after ART(P<0.05).The level of TG,ApoCⅢand ApoE in PI group were significantly higher than that in NNRTI group,while the level of HDL,ApoA in NNRTI group were significantly lower than that in NNRTI group(P<0.05).The total incidence of hyperlipidemia in PI group was higher than that in NNRTI group after treatment(P<0.05).The incidence of neuropsychiatric symptoms and the total incidence of adverse reactions in NNRTI group were higher than those in PI group(P<0.05).Conclusions Elderly patients with HIV infection receiving PI are more likely to develop dyslipidemia and hyperlipidemia.