摘要
目的分析替诺福韦片结合营养支持对艾滋病患者D-二聚体(D-D)、辅助性T淋巴细胞(CD4^(+))水平及肾功能的影响。方法选择艾滋病患者50例,随机分为对照组与观察组,各25例。2组均采用齐多夫定片、拉米夫定片、依非韦伦片进行治疗,对照组在此基础上采用营养支持进行治疗,观察组在对照组基础上采用替诺福韦片治疗,2组均治疗1年。比较2组治疗前后血浆D-D、全血CD4^(+)水平、肾功能、皮褶厚度、体质量指数(BMI)及病毒载量,统计2组治疗期间不良反应发生情况。结果治疗后,观察组肾小球过滤率(eGFR)较治疗前降低,且低于对照组(P<0.05)。治疗后,2组全血CD4^(+)水平、男性、女性皮褶厚度及BMI较治疗前升高,观察组高于对照组(P<0.05)。治疗后,2组血浆D-D水平较治疗前降低,观察组低于对照组(P<0.05)。治疗后,观察组和对照组病毒载量<50 copy·mL;的患者占比(84.00%,56.00%)较治疗前(0.00%,0.00%)显著升高,观察组高于对照组(P<0.05);观察组和对照组病毒载量>1 000 copy·mL;的患者占比(0.00%和20.00%)较治疗前(92.00%与88.00%)显著降低,对照组高于观察组(P<0.05)。治疗期间,观察组和对照组总不良反应发生率比较,差异无统计学意义(P>0.05)。结论替诺福韦片结合营养支持治疗艾滋病患者,可有效降低患者血浆D-D水平,提高患者全血CD4^(+)水平,改善患者凝血功能和免疫功能,同时可改善患者营养状态,病毒清除作用较好,疗效确切,但对患者肾功能有损伤。
Objective To analyze the effects of tenofovir tablets combined with a nutritional support on the D-dimer (D-D) and helper T lymphocyte levels and renal function in AIDS patients.Methods A total of 50 AIDS patients were randomly divided into a control group and an observation group,with 25 cases in each group.Both groups were treated with zidovudine tablets,lamivudine tablets and efavirenz tablets,and the control group was additionally treated with a nutritional support,while the observation group was additionally treated with tenofovir tablets on the basis of the control group,both for one year.The levels of plasma D-D,whole blood CD4^(+),renal function,dermal fold thickness,body mass index (BMI) and viral load were compared between the two groups before and after treatment,and the incidence of adverse reactions during treatment was statistically analyzed.Results After treatment,the glomerular filtration rate (eGFR) in the observation group was lower than that before treatment and lower than that in the control group (P<0.05).One year after treatment,the whole blood CD4^(+)level,skinfold thickness and BMI of men and women in the two groups were higher than those before treatment,and the observation group were higher than the control group (P<0.05).After treatment,the levels of plasma D-D in the two groups were lower than those before treatment,and the observation group was lower than the control group (P<0.05).After treatment,the proportion of patients with viral load < 50 copy·mL;in the observation group and the control group (84.00% and 56.00%) was significantly higher than that before treatment (0.00% and 0.00%),and the observation group was higher than the control group (P<0.05),while the proportion of patients with viral load>1000 copy·mL;in the observation group and the control group (0.00% and 20.00%) was significantly lower than that before treatment (92.00% and 88.00%),and the control group was higher than the observation group (P<0.05).During treatment,there was no significant difference in the incidence of total adverse reactions between the observation group and the control group (P> 0.05).Conclusion Tenofovir tablets combined with the nutritional support can effectively reduce the plasma D-D level,increase the whole blood CD4^(+)level,improve the coagulation function and immune function of patients,and improve their nutritional status,with a good virus clearance and accurate curative effect,yet an impairment in the patients’ renal function.
作者
刘细凤
谢建平
郑丽娜
李小玉
LIU Xifeng;XIE Jianping;ZHENG Lina;LI Xiaoyu(Department of AIDS,the First Hospital of Changsha,Changsha 410001,China;Department of Ultrasound,the First Hospital of Changsha,Changsha 410001,China;Department of Tuberculosis,the First Hospital of Changsha,Changsha 410001,China)
出处
《长春中医药大学学报》
2022年第2期209-212,共4页
Journal of Changchun University of Chinese Medicine
基金
“艾滋病和病毒性肝炎等重大传染病防治”科技重大专项2018年度立项项目(2018ZX10302104)。
