Su Yuan-bo, Xie Jing, Han Yang, Qiu Zhi-feng, Li Yan-ling, Song Xiao-jing, Yu Wei, Li Tai-sheng
Department of Infectious Diseases, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730, China.
Zhonghua Yi Xue Za Zhi. 2012 May 8;92(17):1155-8.
To evaluate the influence of highly active antiretroviral therapy (HAART) on bone mineral density (BMD) in HIV/AIDS patients and correlating clinical factors.
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).
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.
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.
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。
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。
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。
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。
