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HIV阳性患者的外源性和内源性凝血途径、纤维蛋白原血清水平及血小板计数

Extrinsic and intrinsic coagulation pathway, fibrinogen serum level and platelet count in HIV positive patients.

作者信息

Abdollahi Alireza, Shoar Nasrin, Shoar Saeed, Rasoulinejad Mehrnaz

机构信息

Division of Pathology, Imam Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran.

出版信息

Acta Med Iran. 2013 Aug 7;51(7):472-6.

Abstract

Infection with human immunodeficiency virus (HIV) is a progressive condition which may cause endothelial dysfunction and liver damage leading to coagulopathy. With adventure of highly active antiretroviral therapy (HAART), life expectancy has prolonged in HIV positive patients but several acquired immunodeficiency syndrome (AIDS)-related conditions such as coagulopathies are responsible for associated morbidity and mortality. This study aimed to evaluate the extrinsic and intrinsic pathways of coagulation, serum level of fibrinogen and platelet count in HIV positive patients and compare it with negative healthy individuals. Through a case-control study, 114 HIV seropositive patients were compared with 114 seronegative samples in terms of hematological and other coagulation parameters. Mean age of study patients was 37.48 years. Intra venous drug abuse was the most common route of infection transmission with a prevalence of more than 50%. HIV route of transmission had a direct relationship with PTT abnormal levels (P<0.0001). However, this relationship was not significant for PT values. Stages of HIV disease and administration of HAART did not reveal any significant relationship with PT and PTT. There was also a statistically significant correlation between CD4+< 200 and PT in case group (P=0.008). On the other hands, in control group, CD4+ had a weak relationship with PTT (P=0.02) and an inverse correlation with serum fibrinogen (P=0.013). Hematological parameters and serum fibrinogen are decreased in HIV positive patients especially in direct relation with CD4+ cell count<200 cell/µl. PT and PTT abnormal values are also more prevalent in this population.

摘要

感染人类免疫缺陷病毒(HIV)是一种进行性疾病,可能导致内皮功能障碍和肝损伤,进而引发凝血病。随着高效抗逆转录病毒疗法(HAART)的出现,HIV阳性患者的预期寿命得以延长,但一些与获得性免疫缺陷综合征(AIDS)相关的病症,如凝血病,却是导致相关发病率和死亡率的原因。本研究旨在评估HIV阳性患者凝血的内源性和外源性途径、纤维蛋白原血清水平及血小板计数,并与健康阴性个体进行比较。通过病例对照研究,对114例HIV血清阳性患者和114例血清阴性样本的血液学及其他凝血参数进行了比较。研究患者的平均年龄为37.48岁。静脉药物滥用是最常见的感染传播途径,患病率超过50%。HIV传播途径与部分凝血活酶时间(PTT)异常水平存在直接关系(P<0.0001)。然而,这种关系对于凝血酶原时间(PT)值并不显著。HIV疾病阶段和HAART的使用与PT和PTT均未显示出任何显著关系。病例组中CD4+<200与PT之间也存在统计学显著相关性(P=0.008)。另一方面,在对照组中,CD4+与PTT存在较弱关系(P=0.02),与血清纤维蛋白原呈负相关(P=0.013)。HIV阳性患者的血液学参数和血清纤维蛋白原降低,尤其是与CD4+细胞计数<200个细胞/微升直接相关。PT和PTT异常值在该人群中也更为普遍。

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