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喀麦隆雅温得地区HIV感染者的止血趋势:一项试点研究。

Haemostatic trends in HIV-infected individuals in Yaoundé, Cameroon: a pilot study.

作者信息

Tene Larissa, Tagny Claude T, Mintya-Ndoumba Annick, Fossi Victor N, Mbanya Dora

机构信息

aInstitut Supérieur des Sciences de la Santé, Université des Montagnes, Bangangté bFaculty of Medicine and Biomedical Sciences, University of Yaoundé cUniversity Teaching Hospital Yaoundé, Yaoundé, Cameroon dFaculté de Médecine, Université de Bangui, Bangui, Central African Republic.

出版信息

Blood Coagul Fibrinolysis. 2014 Jul;25(5):422-5. doi: 10.1097/MBC.0000000000000066.

Abstract

Bleeding disorders are haematological manifestations that are frequently observed during HIV infection. This study intends to describe the haemostatic trends in HIV-infected patients in Cameroon. This cross-sectional descriptive study was carried out at the haematology unit of the Yaoundé University Teaching Hospital from March to June 2012. It included consenting HIV-positive patients, aged 18 years and above, naive to antiretroviral treatment or not. The coagulation profile was measured with Stago reagents (Stago Diagnostics, Asnières sur Seine, France) using a chronometric technique on a semi-automate (Stago Diagnostics). Platelets count was estimated on a human count automate (Human Diagnostics, Wiesbaden, Germany) by flow cytometry. A total of 139 HIV-infected patients were included in this study, out of which 106 were females (76.3%) against 33 (23.7%) males, giving a sex ratio of 0.3 (M/F). Mean age was 38.85 years (range 22-73 years) and median CD4 count was 353 cells/μl (Interquartile range 200-500 cells/μl). Hyperfibrinogenaemia was the most frequent bleeding disorder in the studied population [40 of 139 (28.78%)], followed by low prothrombin time (PT) [22 of 139 (15.83%)], thrombocytopenia [19 of 139 (13.67%)], hypofibrinogenaemia [18 of 139 (12.95)], prolonged activated partial thromboplastin time (7.91) and by thrombocytosis which was less frequent [6 of 139 (4.32%)]. Out of the six haemostatic disorders, only low PT was significantly associated with CD4 count (P = 0.02). This study showed that bleeding disorders are very frequent in the HIV-infected patients studied. Low PT was significantly associated with CD4 count, hence it may be recommended to systematic screen for bleeding disorders in severe immune-depressed (CD4 ≤ 200 cells/μl) HIV-infected patients.

摘要

出血性疾病是艾滋病毒感染期间经常观察到的血液学表现。本研究旨在描述喀麦隆艾滋病毒感染患者的止血趋势。这项横断面描述性研究于2012年3月至6月在雅温得大学教学医院血液科进行。研究对象包括18岁及以上、未接受过抗逆转录病毒治疗或已接受治疗的自愿参与的艾滋病毒阳性患者。使用Stago试剂(法国塞纳河畔阿涅尔的Stago诊断公司)通过计时技术在半自动仪器(Stago诊断公司)上测量凝血指标。通过流式细胞术在血细胞自动分析仪(德国威斯巴登的Human诊断公司)上估计血小板计数。本研究共纳入139名艾滋病毒感染患者,其中女性106名(76.3%),男性33名(23.7%),性别比为0.3(男/女)。平均年龄为38.85岁(范围22 - 73岁),CD4计数中位数为353个细胞/μl(四分位间距200 - 500个细胞/μl)。高纤维蛋白原血症是研究人群中最常见的出血性疾病[139例中有40例(28.78%)],其次是凝血酶原时间(PT)降低[139例中有22例(15.83%)]、血小板减少症[139例中有19例(13.67%)]、低纤维蛋白原血症[139例中有18例(12.95%)]、活化部分凝血活酶时间延长[139例中有7例(5.04%)]以及血小板增多症,后者较少见[139例中有6例(4.32%)]。在这六种止血障碍中,只有PT降低与CD4计数显著相关(P = 0.02)。本研究表明,在所研究的艾滋病毒感染患者中出血性疾病非常常见。PT降低与CD4计数显著相关,因此建议对严重免疫抑制(CD4≤200个细胞/μl)的艾滋病毒感染患者进行出血性疾病的系统筛查。

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