不同抗病毒方案治疗HIV/AIDS患者实验室生化指标变化分析

Changes of laboratory biochemical indicators in HIV/AIDS patients treated with different antiviral regimens

目的 分析不同治疗方案各个随访时间点肝肾功及血糖血脂代谢指标的变化情况,旨在为临床优化和调整用药提供参考依据。方法 回顾性分析7个随访时间点肝肾功及血糖血脂代谢指标的变化情况,以HIV/AIDS患者基线采血时间为起点,最后随访时间为终点。7个随访点分别为0、3、6、9、12、18、24个月。结果 肝功能:E组治疗方案在治疗9M、12M、18M和24M后T-Bil水平高于基线(P<0.01);F组在治疗9M后T-Bil水平高于基线(P=0.001);C组在治疗后六个随访点的ALT水平皆高于基线(P<0.001);C组在治疗3M和6M后AST水平高于基线(P<0.05)。肾功能:C组在治疗6M后UREA水平高于基线(P=0.007);F组在治疗12M后UREA水平高于基线(P<0.001);F组治疗3M、6M和12M后UA水平高于基线(P<0.05)。血脂血糖:A组、C组ART治疗后部分随访点的Glu水平高于基线(P<0.05);A组、E组和F组ART治疗后部分随访点的TG水平高于基线(P<0.05);A组、B组、C组、E组和F组ART治疗后部分随访点的TC水平皆高于基线(P<0.05)。结论 定期监测ART过程中不同治疗方案实验室指标的变化对患者的预后至关重要,应针对不同的治疗方案重点监测不同的实验室指标,有效预防不同治疗方案所引起的不良反应。

Objective To analyze the changes of liver and kidney function,blood glucose and lipid metabolism at different follow-up time points of different treatment regimens,and to provide reference for clinical optimization and adjustment of medication in HIV/AIDS patients.Methods The changes of liver and kidney function,blood glucose and lipid metabolism at seven follow-up time points were analyzed retrospectively.The baseline blood collection time of HIV/AIDS patients was set as the starting point,and the final follow-up time was set as the end point.The seven follow-up points were 0,3,6,9,12,18 and 24 months respectively.Results There were statistically significant differences in the distribution of sex,age,education,marital status,WHO staging,infection route,and baseline CD4+T lymphocyte count among 605 enrolled patients based on different treatment regimens.Liver function:The level of T-Bil in group E was higher than that of baseline at 9M,12M,18M and 24M after treatment(P<0.01);In group F,the level of T-Bil was higher than that of baseline at 9M after treatment(P=0.001);The levels of ALT in group C at the six follow-up points after treatment were higher than the baseline(P<0.001);The level of AST in group C was higher than that of baseline after 3M and 6M treatment(P<0.05).Renal function:The level of UREA in group C was higher than that in baseline after 6M treatment(P=0.007);The level of UREA in group F was higher than that in the baseline after 12M treatment(P<0.001);The level of UA in group F was higher than that of baseline after 3M,6M and 12M treatment(P<0.05).Blood lipid and blood glucose:The levels of Glu at some follow-up points after ART treatment in group A and group C were higher than that at baseline(P<0.05);The levels of TG at some follow-up points in group A,group E and group F after ART treatment were higher than those at baseline(P<0.05);The levels of TC at some follow-up points in group A,group B,group C,group E and group F after ART treatment were all higher than the baseline(P<0.05).Conclusion Regular monitoring of changes in laboratory indicators of different treatment regimens during ART is of great importance to the prognosis of patients.Different laboratory indicators should be monitored according to different treatment regimens to effectively prevent adverse reactions caused by different treatment regimens.