Kwiatkowska Wiesława, Knysz Brygida, Arczyńska Katarzyna, Drelichowska Justyna, Czarnecki Marcin, Gąsiorowski Jacek, Karczewski Maciej, Witkiewicz Wojciech
Wrovasc - Integrated Cardiovascular Centre, Regional Specialist Hospital, Research and Development Center in Wroclaw, Wroclaw, Poland; Department of Angiology, Regional Specialist Hospital in Wroclaw, Research and Development Center in Wroclaw, Wroclaw, Poland.
Wrovasc - Integrated Cardiovascular Centre, Regional Specialist Hospital, Research and Development Center in Wroclaw, Wroclaw, Poland; Department of Infectious Diseases, Wroclaw Medical University, Wroclaw, Poland.
PLoS One. 2014 Dec 12;9(12):e113857. doi: 10.1371/journal.pone.0113857. eCollection 2014.
Peripheral arterial disease (PAD) is a clinical manifestation of atherosclerosis and mainly refers to elderly patients, having a negative impact on their functionality and quality of life. The findings of previous studies in HIV-infected patients have shown that cardiovascular risk is higher and PAD occurs more frequently than in the general population. There are also contradictory observations. Much less is known about the ankle-brachial index (ABI) value in asymptomatic HIV-infected patients. The aim of this study was to evaluate the prevalence of PAD and ankle-brachial index abnormalities as well as to determine risk factors related to the disease in a group of Polish HIV-positive patients.
One hundred and eleven young to middle aged HIV-positive subjects and 40 noninfected subjects were enrolled into the study. Resting ABI measurements were performed and cardiovascular risk was analysed as well. Subgroups were created according to the ABI values: low (PAD), borderline, normal, high and altered ABI. Symptomatic PAD was observed in 2 HIV-positive patients, asymptomatic PAD was not diagnosed. The ABI value is lower and more varied, in 22.5% of the study group altered ABI values were found. Six subjects demonstrated borderline ABI, and 15 high ABI, including >1.4. In the control group no low or very high values were reported. A relation between low ABI and cardiovascular family history and between altered ABI and high-density-lipoprotein cholesterol (HDL-C) level was demonstrated.
In young and middle-aged HIV-positive patients, symptomatic PAD prevalence is comparable to that observed in the overall population. Among asymptomatic patients PAD is not reported. The ABI value in HIV-positive patients is more varied compared to the HIV-negative subjects; the altered ABI shows a strong relation with low HDL-C levels and metabolic syndrome.
外周动脉疾病（PAD）是动脉粥样硬化的一种临床表现，主要见于老年患者，对其功能和生活质量有负面影响。既往对HIV感染患者的研究结果显示，其心血管疾病风险高于普通人群，PAD的发生率也更高。但也有相互矛盾的观察结果。对于无症状HIV感染患者的踝臂指数（ABI）值，人们了解得更少。本研究的目的是评估一组波兰HIV阳性患者中PAD的患病率、踝臂指数异常情况，并确定与该疾病相关的危险因素。
111名中青年HIV阳性受试者和40名未感染受试者纳入本研究。进行静息ABI测量，并分析心血管疾病风险。根据ABI值分为亚组：低（PAD）、临界、正常、高和ABI改变。2名HIV阳性患者观察到有症状的PAD，未诊断出无症状的PAD。ABI值较低且变化更大，22.5%的研究组发现ABI值改变。6名受试者表现为临界ABI，15名表现为高ABI，包括>1.4。对照组未报告低或非常高的值。低ABI与心血管疾病家族史以及ABI改变与高密度脂蛋白胆固醇（HDL-C）水平之间存在关联。
在中青年HIV阳性患者中，有症状的PAD患病率与总体人群中观察到的相当。在无症状患者中未报告PAD。与HIV阴性受试者相比，HIV阳性患者的ABI值变化更大；ABI改变与低HDL-C水平和代谢综合征密切相关。
Zotero 插件