摘要
目的分析接受抗逆转录病毒治疗(ART)及不同ART方案联合抗结核药物治疗的人类免疫缺陷病毒/艾滋病合并结核分枝杆菌感染(HIV/AIDS-TB)患者在强化期内血液学红细胞系的变化情况。方法选取2014—2017年某传染病专科医院确诊为HIV/AIDS-TB的患者,分为在ART基础上接受抗结核药物联合治疗组(A组),抗结核药物治疗8周内开始ART联合治疗组(B组),抗结核药物治疗8周后开始ART治疗组(C组);检测并比较治疗前基线(0周)和治疗后1、2、4、8周等红细胞系参数红细胞(RBC)、血红蛋白(HGB)、红细胞平均体积(MCV)和红细胞分布宽度(RDW-CV)变化的差异。结果共选取180例HIV/AIDS-TB患者,其中A组71例、B组75例、C组34例;共85.00%(153例)的患者发生轻度贫血,其中A、B、C组分别为84.51%(60/71)、85.33%(64/75)和85.29%(29/34)。抗结核药物治疗后,A、B和C组患者RBC绝对值增减差异均无统计学意义(均P>0.05);治疗4周后,B组患者HGB增加均高于基线(均P<0.05);A、B和C组患者MCV和RDW-CV在治疗后均较基线上升(均P<0.05),但C组治疗8周时RDW-CV恢复至基线水平。A、B两组患者中TDF/3TC/EFV方案在联合抗结核药物治疗4周时,HGB均较基线增高(均P<0.05),其他方案均无统计学意义(均P>0.05)。结论HIV/AIDS-TB患者在抗结核药物治疗后应尽快启动ART治疗,最好8周内开始ART治疗,不同ART方案联合抗结核治疗患者的红细胞系参数变化有差异,TDF治疗方案效果较为理想。
Objective To analyze changes in hematological erythrocyte lineage in patients with HIV/AIDS and Mycobacterium tuberculosis infection (HIV/AIDS -TB) during intensive period of antiretroviral therapy (ART) and different ART regimens combined with anti-tuberculosis drugs. Methods Patients who were confirmed with HIV/AIDS -TB in an infectious disease hospital from 2014 to 2017 were selected and divided into three groups: group A received combination therapy of anti-tuberculosis drugs on the basis of ART,group B started ART within 8 weeks of anti-tuberculosis drug therapy,group C started ART after 8 weeks of anti-tuberculosis drug therapy;changes in parameters of erythrocyte lineage,such as red blood cell(RBC),hemoglobin(HGB),mean corpuscular volume(MCV),and RBC distribution width (RDW-CV) before therapy( baseline,at 0 week) and 1,2,4,and 8 weeks after therapy were detected and compared. Results A total of 180 patients with HIV/AIDS -TB were enrolled,group A,B,and C were 71,75,and 34 cases respectively;85.00%( n =153) of patients developed mild anemia,84.51%(60/71),85.33%(64/75),and 85.29%(29/34) were in group A,B,and C respectively. After anti-tuberculosis drug therapy,changes in absolute value of RBC in group A,B,and C had no significant difference (all P >0.05);after 4 weeks of therapy,increase of HGB in patients in group B was higher than baseline ( P <0.05);MCV and RDW-CV in group A,B,and C after therapy were all higher than baseline (all P <0.05),but RDW-CV in group C recovered to baseline level at 8 weeks of therapy. HGB of group A and B at 4 weeks of TDF/3TC/EFV regimen combined anti-tuberculosis drug therapy were both higher than that of baseline (both P <0.05),but there was no significant difference in other regimens (all P >0.05). Conclusion Patients with HIV/AIDS -TB should start ART as soon as possible after anti-tuberculosis drug therapy,preferably within 8 weeks,changes in erythrocyte parameters in patients treated with different ART regimens combined with anti-tuberculosis therapy are different,effect
作者
舒远路
杨翠先
张米
李健健
邓雪媚
董兴齐
SHU Yuan-lu;YANG Cui-xian;ZHANG Mi;LI Jian-jian;DENG Xue-mei;DONG Xing-qi(School of Public Health,Dali University,Dali 671000,China;Department of Clinical Laboratory,Yunnan Provincial Infectious Disease Hospital,Kunming 650301,China)
出处
《中国感染控制杂志》
CAS
CSCD
北大核心
2019年第5期396-402,共7页
Chinese Journal of Infection Control
基金
云南省科技计划(重点新产品开发)(2016BC005)
关键词
艾滋病
肺结核
抗结核药物治疗
红细胞系
acquired immunodeficiency syndrome
AIDS
pulmonary tuberculosis
anti-tuberculosis drug therapy
erythrocyte lineage
