Lai Shenghan, Lai Hong, Celentano David D, Vlahov David, Ren Shiquan, Margolick Joseph, Lima Joao A C, Bartlett John G
Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland 21205, USA.
AIDS Patient Care STDS. 2003 May;17(5):211-9. doi: 10.1089/108729103321655863.
Recent evidence suggests that as a group protease inhibitors (PIs) may accelerate certain factors associated with atherosclerosis. The objective of this study was to evaluate the effect of individual PIs (indinavir, lopinavir, nelfinavir, ritonavir, and saquinavir) on certain factors associated with atherosclerosis. Persons who took saquinavir and/or ritonavir were compared with those on other PIs. Between May 2000 and July 2001, the lipid profiles, C-reactive protein (CRP) levels, coronary artery calcium (CAC) scores, and blood cell morphologic parameters were measured in 98 black adult participants aged 25 to 45 years with HIV-1 infection in Baltimore, Maryland. Among these 98, there were 55 (56.1%) taking PIs. Students' t-test and chi2 test were used to detect the between-group differences. Study participants in both the PI and non-PI groups were similar in age, sex, body mass index, blood pressure, red and white blood cell counts, time since HIV diagnosis, and duration on anti-retroviral therapy. Compared with those who took non-PI regimens, those who took indinavir, nelfinavir, or saquinavir had significantly higher levels of mean corpuscular volume (MCV) and mean corpuscular hemoglobin (MCH). Those taking any PI had significantly higher total cholesterol and low-density lipoprotein. Those taking nelfinavir, ritonavir, or saquinavir were more likely to have a higher CAC score (>5) than those on non-PI regimens. There were no differences in the lipid profiles, MCV, MCH, CRP, and CAC between those taking saquinavir and/or ritonavir and those taking other PIs. Overall, the changes noted might lead to anticipation of clinical changes linked to accelerated atherosclerosis in patients on PIs.
近期证据表明，作为一个药物类别，蛋白酶抑制剂（PIs）可能会加速某些与动脉粥样硬化相关的因素。本研究的目的是评估个体蛋白酶抑制剂（茚地那韦、洛匹那韦、奈非那韦、利托那韦和沙奎那韦）对某些与动脉粥样硬化相关因素的影响。将服用沙奎那韦和/或利托那韦的人与服用其他蛋白酶抑制剂的人进行比较。在2000年5月至2001年7月期间，对马里兰州巴尔的摩市98名年龄在25至45岁之间感染HIV-1的黑人成年参与者进行了血脂谱、C反应蛋白（CRP）水平、冠状动脉钙化（CAC）评分和血细胞形态学参数的测量。在这98人中，有55人（56.1%）服用蛋白酶抑制剂。采用学生t检验和卡方检验来检测组间差异。蛋白酶抑制剂组和非蛋白酶抑制剂组的研究参与者在年龄、性别、体重指数、血压、红细胞和白细胞计数、自确诊HIV以来的时间以及抗逆转录病毒治疗持续时间方面相似。与服用非蛋白酶抑制剂方案的人相比，服用茚地那韦、奈非那韦或沙奎那韦的人平均红细胞体积（MCV）和平均红细胞血红蛋白含量（MCH）水平显著更高。服用任何蛋白酶抑制剂的人总胆固醇和低密度脂蛋白水平显著更高。服用奈非那韦、利托那韦或沙奎那韦的人比服用非蛋白酶抑制剂方案的人更有可能有更高的冠状动脉钙化评分（>5）。服用沙奎那韦和/或利托那韦的人与服用其他蛋白酶抑制剂的人在血脂谱、平均红细胞体积、平均红细胞血红蛋白含量、C反应蛋白和冠状动脉钙化方面没有差异。总体而言，所观察到的变化可能会让人预期服用蛋白酶抑制剂的患者会出现与动脉粥样硬化加速相关的临床变化。
