巴西一家三级护理大学医院传染病门诊对艾滋病患者的功能呼吸参数进行评估。

Evaluation of functional respiratory parameters in AIDS patients assisted in the infectious diseases ambulatory care clinic of a tertiary care university hospital in Brazil.

机构信息

Internal Medicine Department, State University of Campinas, São Paulo, Brazil.

出版信息

Respir Care. 2012 Apr;57(4):544-9. doi: 10.4187/respcare.01362. Epub 2011 Oct 13.

DOI:10.4187/respcare.01362

PMID:22005279

Abstract

BACKGROUND

Pulmonary function, in HIV infected patients, has been associated with reduction in pulmonary ventilation parameters.

METHODS

We conducted a prospective cross sectional study to evaluate the pulmonary function of AIDS patients cared for in the infectious diseases ambulatory care clinic. Maximal inspiratory (P(Imax)) and expiratory (P(Emax)) pressures and spirometry were assessed. Clinical, demographic, and laboratory data were also evaluated.

RESULTS

P(Imax) and P(Emax) were assessed in 73 and spirometry in 54 subjects. The mean time of HIV infection (in years) was similar for men (8.5 ± 5.1 y) and women (10.4 ± 4.2 y, P = .13), and the mean time of use of antiretroviral therapy was 8.5 ± 4.1 years for women and 7.7 ± 4.1 years for men (P = .46). P(Imax) and P(Emax) values were normal in 35 (48%) and 48 (66%) subjects, respectively. The use of tenofovir and presence of cough, by the time the test was performed, were independently associated with P(Emax) below the predicted value. Elevated creatine kinase values were associated with prolonged antiretroviral usage (9.6 ± 4.1 y vs 7.4 ± 3.9 y, P = .05). FVC was reduced in 14 (26.4%) subjects and was independently associated with high and/or intermediate cardiovascular risk (P = .002), and those with reduced vesicular murmur in auscultation (P = .047). FEV(1) was significantly lower in subjects with prolonged time of smoking (P = .02) and high and/or intermediate cardiovascular risk (P = .003). Reduced FEV(1)/FVC was associated with smoking (P = .041).

CONCLUSIONS

AIDS subjects, in our study, had reduced parameters of maximal respiratory pressures and spirometry. The frequent dysfunction of respiratory muscles might be due to the association of multiple factors and not a particular one; moreover, smoking was independently associated with abnormal airway function. Pulmonary function tests should be implemented as an essential part of the medical assistance to AIDS patients.

摘要

背景

在 HIV 感染者中，肺功能与肺通气参数降低有关。

方法

我们进行了一项前瞻性的横断面研究，以评估在传染病门诊就诊的 AIDS 患者的肺功能。评估了最大吸气（P(Imax)）和最大呼气（P(Emax)）压力和肺活量计。还评估了临床、人口统计学和实验室数据。

结果

在 73 名患者中评估了 P(Imax)和 P(Emax)，在 54 名患者中评估了肺活量计。男性（8.5 ± 5.1 年）和女性（10.4 ± 4.2 年）的 HIV 感染时间（年）相似，女性和男性的抗逆转录病毒治疗时间分别为 8.5 ± 4.1 年和 7.7 ± 4.1 年（P =.46）。35 名（48%）和 48 名（66%）患者的 P(Imax)和 P(Emax)值正常。在进行测试时使用替诺福韦和咳嗽是与低于预测值的 P(Emax)相关的独立因素。肌酸激酶升高与延长抗逆转录病毒使用时间相关（9.6 ± 4.1 年 vs 7.4 ± 3.9 年，P =.05）。14 名（26.4%）患者的 FVC 降低，与高/中和/低心血管风险相关（P =.002），并且在听诊时出现水泡音减弱的患者（P =.047）。在吸烟时间延长的患者中 FEV(1)显著降低（P =.02）和高/中和/低心血管风险（P =.003）。FEV(1)/FVC 降低与吸烟有关（P =.041）。