茚地那韦治疗HIV感染人群中泌尿系结石成分分析及发病风险研究

Composition and risk of urolithiasis in HIV infected individuals treated with indinavir

目的探讨人类免疫缺陷病毒(HIV)感染人群中服用茚地那韦与泌尿系结石发病的相关性,分析研究服用茚地那韦与服用其他抗HIV逆转录病毒药物患者的结石成分差异,为HIV感染患者泌尿系结石临床防治提供参考。方法回顾性分析自2016年7月至2023年1月长沙市第一医院收治的1150例HIV感染者的临床资料,分为服用茚地那韦组(观察组)与服用其他抗HIV逆转录病毒药物组(对照组),比较两组泌尿系结石发病率,并收集180例结石标本进行结石成分分析,分析比较两组结石成分构成及差异。结果观察组泌尿系结石发病率高于对照组(P<0.05);两组结石成分均以草酸钙类为主,在磷酸钙类、磷酸铵镁、尿酸类结石分布上比较差异无统计学意义(P>0.05),但观察组草酸钙类结石少于对照组,茚地那韦药物结石多于对照组(P<0.05);两组在结石治疗6个月后复发率比较差异无统计学意义(P>0.05)。结论服用茚地那韦治疗HIV感染会增加泌尿系结石发病风险,其药物性结石,即茚地那韦结石发生率高于其他药物组,可根据结石成分分析结果,制定个体化防治方案,如服药时水化尿液等重要举措,以降低结石复发率,提高治疗效果。

【Objective】To investigate the correlation between the use of indinavir and the incidence of urolithiasis in human immunodeficiency virus(HIV)infected individuals,and analyze the differences in stone composition between patients taking indinavir and those taking other anti-HIV retroviral drugs,so as to provide reference for the clinical prevention and treatment of urolithiasis in HIV infected patients.【Methods】The clinical data of 1150 HIV infected patients admitted to the First Hospital of Changsha from July 2016 to January 2023 were retrospectively analyzed.They were divided into two groups:the treatment group with indinavir(observation group)and the treatment group with other anti-HIV retroviral drugs(control group).The incidence rate of urolithiasis in the two groups were compared.Totally 180 stone samples were collected for calculus composition analysis,and the composition and difference of calculus composition between the two groups were analyzed.【Results】The incidence rate of urolithiasis in the observation group was significantly higher than that in the control group(P<0.05).Both groups of stones were mainly composed of calcium oxalate,and there was no significant difference in the distribution of calcium phosphate,magnesium ammonium phosphate,and uric acid stones(P>0.05).However,the observation group had fewer calcium oxalate stones compared with the control group,and the number of indinavir induced stones was significantly increased compared with the control group(P<0.05).There was no significant difference in the recurrence rate between the two groups after 6 months of stone treatment(P>0.05).【Conclusion】Taking indinavir to treat HIV infection increases the risk of urinary tract stones.The composition and recurrence rate of stones are not significantly different from those of patients taking other anti HIV drugs.Therefore,personalized prevention and treatment plans should be developed based on the analysis of stone components to reduce stone recurrence rate and improve treatment effectiveness.However,the incidence of drug-induced stones,namely indinavir stones,is higher than that of other drug groups.Hydrating urine during medication is an important measure to reduce the recurrence of urinary system stones.