摘要
目的了解人类免疫缺陷病毒(Human immunodeficiency virus,HIV)感染者使用含富马酸替诺福韦酯(TDF)方案抗病毒治疗(Antiviral treatment,ART)后骨密度(Bone mineral density,BMD)的变化。方法随机选取2018年5月至7月到昆明市第三人民医院复诊领药的患者90例,给患者进行双能X线骨密度检查,部分进行25羟维生素D的检测,并收集性别、年龄、体重、身高、抗病毒治疗时间、使用含TDF方案的时间等临床资料。结果90例使用含TDF方案抗病毒治疗的患者,骨量减少占40.0%,骨质疏松占31.1%。其中,13例25羟维生素D检测的患者,30.8%为25羟维生素D缺乏,61.5%为25羟维生素D不足。年龄≥50岁组患者91.8%检出骨量减少/骨质疏松,显著高于年龄小于50岁组(46.3%)(P<0.001)。男性患者检出骨量减少/骨质疏松43例(79.6%),显著高于女性患者(58.3%)(P=0.029)。年龄≥50岁是HIV感染者抗病毒治疗后骨量减少/骨质疏松的危险因素(OR=21.005,P<0.001),女性是HIV感染者抗病毒治疗后骨量减少/骨质疏松的保护性因素(OR=0.172,P=0.006)。结论使用含TDF方案抗病毒治疗的HIV感染者中,骨密度降低的发生率高,25羟维生素D缺乏及不足的发生率高,需要定期监测,年龄在50岁及以上的男性患者是主要筛查对象。
Objective To evaluate the impact of antiretroviral therapy with TDF regimen on bone mineral density in HIV-infected patients. Methods A total of 90 HIV-infected patients with antiretroviral therapy in clinic of Infectious Department in Kunming 3 rd People’s Hospital were randomly selected for the study from May 2018 to July 2018.All patients bone mineral density were measured by dual energy X-ray absorptiometry. Some of them tested the 25 hydroxy vitamin D. Data including the gender, age, body weight, height, medication time with HAART and with TDF were collected. Results There were 40% patients with osteopenia and 31.1% patients with osteoporosis in 90 HIV-infected patients treated with ART containing TDF. There were 30.8% patients with VitD deficient and 61.5% patients with VitD insufficient in 13 HIV-infected patients which were tested 25 hydroxy vitamin D. The prevalence of osteopenia/osteoporosis was statistically higher in the age ≥ 50 group(91.8%) than that in the age < 50 group(46.3%)( P < 0.001).The prevalence of osteopenia/osteoporosis was statistically higher in the male group(79.6%) than that in the female group(58.3%)(P=0.029).The age ≥ 50 was the risk factors of osteopenia/osteoporosis(OR=21.005,P < 0.001) after ART. Female was the protective factors of osteopenia/osteoporosis(OR=0.172,P=0.006) after ART. Conclusion The prevalence of osteopenia and osteopomsis and VitD deficient in HIV-infected patients treated with ART containing TDF is high. Special attention should be paid to monitor the bone mineral density in male patients with the age ≥ 50 years.
作者
李重熙
田波
何蓉
关玮
房梅芹
白劲松
刘俊
李海雯
LI Chong-xi;TIAN Bo;HE Rong;GUAN Wei;FANG Mei-qin;BAI Jin-song;LIU Jun;LI Hai-wen(Kunming 3rd People's Hospital,Kunming,Yunnan 650041)
出处
《皮肤病与性病》
2019年第5期639-641,共3页
Dermatology and Venereology
关键词
HIV感染
抗病毒治疗
骨密度
TDF
HIV infection
Antiviral treatment
Bone mineral density
Tenofovir fumarate
