摘要
目的评价长期高效抗逆转录病毒治疗（HAART）对HIV／AIDS患者骨密度（BMD）的影响及相关因素。方法招募2001-2011年北京协和医院收治的149例HIV感染患者，其中未治疗组41例，治疗1-2年组60例，治疗〉5年组48例，以20名健康志愿者为对照组。经双能X线骨密度吸收仪（DXA）测量全身、腰椎1-4、右髋部和右股骨颈BMD-Z值及T值。结果治疗〉5年组右髋部BMD．Z值（0．16±0．82）显著低于未治疗组（0．61±1．09）（P=0．039）。治疗〉5年组右股骨颈BMD．Z值（-0．002±0．87）显著低于未治疗组（0．55±1．08）（P=0．012）。治疗1-2年组BMD-Z值与治疗〉5年组、未治疗组及健康对照组差异无统计学意义。治疗1-2年组及治疗〉5年组骨量减少／骨质疏松发生率显著高于未治疗组。右髋部及右股骨颈BMD-Z值与HAART时间呈负相关。体重是影响骨量减少／骨质疏松发生的重要危险因素。结论治疗〉5年组患者髋部及股骨颈BMD显著下降；接受HAART治疗后骨量减少／骨质疏松发生率显著增加。BMD变化与HAART时间呈负相关。长期接受HAART患者合并高龄、体重减低等危险因素需定期复查DXA。
Objective To evaluate the influence of highly active antiretroviral therapy （HAART） on bone mineral density （BMD） in HIV/AIDS patients and correlating clinical factors. Methods 149 HIV patients were divided into 3 groups：untreated group with 41 patients, HAART for 1 -2 years group with 60 patients , HAART over 5 years group with 48 patients; 20 healthy individuals included as a control group. BMD-T score and BMD-Z score were measured by dual-energy X-ray absorptiometry （DXA）. Results BMD-Z score of right hip was significantly lower in HAART over 5 years group （ 0. 16 ± 0. 82 ） than untreated group （0. 61± 1.09） （P =0. 039）. BMD-Z score of right femoral neck was significantly lower in HAART over 5 years group （ -0. 002 ±0. 87） than untreated group（0. 55 ± 1.08） （ P =0. 012）. BMD-Z score of HAART for 1 - 2 years group was not significantly decreased. BMD-Z score of right hip and right femoral neck were correlated negatively with HAART duration. The incidence of osteopenia/osteoprosis in HAART for 1 -2 years group （31.7%） and HAART over 5 years group （31.3%） were significantly higher than untreated group （ 12. 2% ） （ P 〈 0. 05 ）. Body weight was revealed as a risk factor of osteopenia/ osteoporosis. Conclusion BMD of right hip and right femur neck were significantly lower in HAART over 5 years group. The incidence of osteopenia/osteoprosis were significantly higher in patients receiving HAART. BMD were correlated negatively with HAART duration. Patients in long-term HAART combined with risk factors such as old age or lower body weight should be checked by DXA regularly.
出处
《中华医学杂志》
CAS
CSCD
北大核心
2012年第17期1155-1158,共4页
National Medical Journal of China
基金
国家“十一五”艾滋病和病毒性肝炎等重大传染病防治科技重大专项（2008ZX10001-006）
卫生部部属（管）医院临床学科重点项目（2010-2012）
