抗病毒治疗HIV感染者/艾滋病患者并发高血压相关因素研究

Factors associated with hypertension in HIV/AIDS patients undergoing antiviral therapy

目的 了解规范接受抗病毒治疗(antiretroviral therapy,ART)的人类免疫缺陷病毒(human immunodeficiency virus,HIV)感染/艾滋病患者并发高血压的相关因素。方法 采用病例对照研究方法,将并发高血压的HIV感染者/艾滋病患者作为病例组,按性别、年龄(±3岁) 1∶1匹配的216例未患高血压的HIV感染者/艾滋病患者作为对照组。收集两组患者的一般人口学资料、临床特征、炎症指标等因素,应用条件logistics回归分析发生高血压的相关因素。结果 吸烟(OR=5.03,95%CI:1.18-21.51)、体质量指数(body mass index, BMI)≥24.0kg/m^(2)(OR=3.55, 95%CI:1.28-9.83)、空腹血糖≥7.0 mmol/L (OR=5.47,95%CI:1.21-24.77)、肌酐(OR=1.01,95%CI:1.00-1.02)、超敏C反应蛋白(high-sensitivity C-reactive protein,hs-CRP)(OR=3.24,95%CI:1.12-9.37)、中性粒细胞/淋巴细胞比值(neutrophil to lymphocyte ratio,NLR)(OR=1.26,95%CI:1.03-1.56)、HIV感染者/艾滋病患者确诊时间5-<10年(OR=13.28,95%CI:1.59-111.00)、接受ART时间≥10年(OR=19.43,95%CI:1.13-334.07)、入院CD4^(+)T细胞≥350个/μl (OR=5.99, 95%CI:1.56-22.96)、低HIV-RNA (OR=4.63, 95%CI:1.47-14.63)是发生高血压的危险因素,入院高CD4^(+)T/CD8^(+)T比值(OR=0.24,95%CI:0.07-0.82)是其保护因素。结论 对规范接受ART的艾滋病患者定期监测危险因素,可早期预警高血压的发生。

Objective To explore the factors associated with co-occurrence of hypertension in human immunodeficiency virus(HIV)-infected people and acquired immunodeficiency syndrome(AIDS)patients receiving standard antiretroviral therapy(ART).Methods A case-control study was conducted,in which 216 HIV/AIDS patients with hypertension were selected as cases,and 216 HIV/AIDS patients without hypertension 1:1 matched by sex and age(±3 years)were selected as controls.Demographic data,clinical characteristics,inflammation indicators and other factors of the patients in the two groups were collected.Conditional logistic regression was used to analyze the factors associated with hypertension.Results Smoking(OR=5.03,95%CI:1.18-21.51),body mass index(BMI)≥24.0 kg/m^(2)(OR=3.55,95%CI:1.28-9.83),fasting blood glucose≥7.0 mmol/L(OR=5.47,95%CI:1.21-24.77),creatinine(OR=1.01,95%CI:1.00-1.02),high-sensitivity C-reactive protein(OR=3.24,95%CI:1.12-9.37),neutrophil to lymphocyte ratio(OR=1.26,95%CI:1.03-1.56),HIV/AIDS diagnosis within the prior 5-<10 years(OR=13.28,95%CI:1.59-111.00),ART duration≥10 years(OR=19.43,95%CI:1.13-334.07),CD4 cell counts≥350 cells/μl upon admission(OR=5.99,95%CI:1.56-22.96),and low HIV-RNA(OR=4.63,95%CI:1.47-14.63)were risk factors for co-occurrence of hypertension in HIV/AIDS cases,and high CD4/CD8 ratio upon admission(OR=0.24,95%CI:0.07-0.82)was a protective factor against hypertension in HIV/AIDS.Conclusions Regular monitoring of risk factors among HIV/AIDS patients receiving standard ART may facilitate early-warning of the occurrence of hypertension.