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[长期高效抗逆转录病毒疗法对HIV/AIDS患者骨密度的影响]

[Influence of long-term highly active antiretroviral therapy on bone mineral density in HIV/AIDS patients].

作者信息

Su Yuan-bo, Xie Jing, Han Yang, Qiu Zhi-feng, Li Yan-ling, Song Xiao-jing, Yu Wei, Li Tai-sheng

机构信息

Department of Infectious Diseases, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730, China.

出版信息

Zhonghua Yi Xue Za Zhi. 2012 May 8;92(17):1155-8.

Abstract

OBJECTIVE

To evaluate the influence of highly active antiretroviral therapy (HAART) on bone mineral density (BMD) in HIV/AIDS patients and correlating clinical factors.

METHODS

149 HIV patients were divided into 3 groups:untreated group with 41 patients, HAART for 1-2 years group with 60 patients, HAART over 5 years group with 48 patients; 20 healthy individuals included as a control group. BMD-T score and BMD-Z score were measured by dual-energy X-ray absorptiometry (DXA).

RESULTS

BMD-Z score of right hip was significantly lower in HAART over 5 years group (0.16 ± 0.82) than untreated group (0.61 ± 1.09) (P = 0.039). BMD-Z score of right femoral neck was significantly lower in HAART over 5 years group (-0.002 ± 0.87) than untreated group (0.55 ± 1.08) (P = 0.012). BMD-Z score of HAART for 1-2 years group was not significantly decreased. BMD-Z score of right hip and right femoral neck were correlated negatively with HAART duration. The incidence of osteopenia/osteoporosis in HAART for 1 - 2 years group (31.7%) and HAART over 5 years group (31.3%) were significantly higher than untreated group (12.2%) (P < 0.05). Body weight was revealed as a risk factor of osteopenia/osteoporosis.

CONCLUSION

BMD of right hip and right femur neck were significantly lower in HAART over 5 years group. The incidence of osteopenia/osteoporosis were significantly higher in patients receiving HAART. BMD were correlated negatively with HAART duration. Patients in long-term HAART combined with risk factors such as old age or lower body weight should be checked by DXA regularly.

摘要

目的

评估高效抗逆转录病毒治疗(HAART)对HIV/AIDS患者骨密度(BMD)的影响及相关临床因素。

方法

149例HIV患者分为3组:未治疗组41例,HAART治疗1 - 2年组60例,HAART治疗超过5年组48例;20名健康个体作为对照组。采用双能X线吸收法(DXA)测量BMD - T值和BMD - Z值。

结果

HAART治疗超过5年组右髋部的BMD - Z值(0.16±0.82)显著低于未治疗组(0.61±1.09)(P = 0.039)。HAART治疗超过5年组右股骨颈的BMD - Z值(-0.002±0.87)显著低于未治疗组(0.55±1.08)(P = 0.012)。HAART治疗1 - 2年组的BMD - Z值无显著下降。右髋部和右股骨颈的BMD - Z值与HAART治疗持续时间呈负相关。HAART治疗1 - 2年组(31.7%)和HAART治疗超过5年组(31.3%)的骨质减少/骨质疏松发生率显著高于未治疗组(12.2%)(P < 0.05)。体重被揭示为骨质减少/骨质疏松的一个危险因素。

结论

HAART治疗超过5年组右髋部和右股骨颈的骨密度显著降低。接受HAART治疗的患者骨质减少/骨质疏松发生率显著更高。骨密度与HAART治疗持续时间呈负相关。长期接受HAART治疗且合并老年或体重较低等危险因素的患者应定期进行DXA检查。

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