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HIV阳性和HIV阴性中风幸存者在功能恢复方面的差异。

The differences in functional recovery between HIV-positive and HIV-negative stroke survivors.

作者信息

van Rensburg Jenny Janse, Mudzi Witness, Ntsiea Veronica

机构信息

Department of Physiotherapy, School of Therapeutic Sciences, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.

出版信息

Turk J Phys Med Rehabil. 2018 Nov 3;64(4):314-321. doi: 10.5606/tftrd.2018.1708. eCollection 2018 Dec.

Abstract

OBJECTIVES

This study aims to identify the differences in functional abilities between stroke survivors who are human immunodeficiency virus (HIV)-positive and HIV-negative.

PATIENTS AND METHODS

This was a retrospective, longitudinal record review of stroke survivors' files between April 2005 and December 2010. Of a total of 173 stroke survivors who were admitted to the rehabilitation unit, 141 (75 males, 66 females; mean age 52.7±14.3 years; range, 19 to 86 years) met the inclusion criteria. The patients were divided into two groups as HIV-positive (n=21) and HIV-negative (n=120). Functional ability was recorded using the admission and discharge BETA® scores.

RESULTS

Ischemic strokes were more prevalent than hemorrhagic strokes (74.5% vs. 25.5%, respectively) with hypertension as the most common (31.9%) stroke risk factor. The mean age of stroke onset for HIV-positive patients and HIV-negative patients was 39.6 years and 54.9 years, respectively. In HIV-positive patients, the mean duration of rehabilitation was 7.5-day shorter than HIV-negative patients. After receiving rehabilitation from a multidisciplinary team, the HIV-positive group improved with a mean of 40 points and the HIV-negative group improved with a mean of 38 points. The similarities in functional outcome between the HIV-positive and HIV-negative group were related to the fact that HIV-positive stroke survivors were relatively younger than the HIV-negative group.

CONCLUSION

Our study results show that patients who sustain a stroke, are HIV-positive, are receiving antiretroviral therapy and rehabilita- tion may recover similar to those who are HIV-negative, spending a similar length of stay in a rehabilitation clinic. Therefore, stroke survivors who are HIV-positive should receive full rehabilitation similar to any other stroke survivors.

摘要

目的

本研究旨在确定人类免疫缺陷病毒(HIV)阳性和HIV阴性的中风幸存者在功能能力上的差异。

患者与方法

这是一项对2005年4月至2010年12月期间中风幸存者档案的回顾性纵向记录研究。在总共173名入住康复科的中风幸存者中,141名(75名男性,66名女性;平均年龄52.7±14.3岁;年龄范围19至86岁)符合纳入标准。患者被分为HIV阳性组(n = 21)和HIV阴性组(n = 120)。使用入院和出院时的BETA®评分记录功能能力。

结果

缺血性中风比出血性中风更常见(分别为74.5%和25.5%),高血压是最常见的(31.9%)中风危险因素。HIV阳性患者和HIV阴性患者中风发作的平均年龄分别为39.6岁和54.9岁。在HIV阳性患者中,康复的平均时长比HIV阴性患者短7.5天。在接受多学科团队的康复治疗后,HIV阳性组平均提高了40分,HIV阴性组平均提高了38分。HIV阳性组和HIV阴性组在功能结局上的相似性与HIV阳性中风幸存者比HIV阴性组相对更年轻这一事实有关。

结论

我们的研究结果表明,中风、HIV阳性、正在接受抗逆转录病毒治疗和康复的患者可能与HIV阴性患者恢复情况相似,在康复诊所的住院时间也相似。因此,HIV阳性的中风幸存者应接受与其他中风幸存者相同的全面康复治疗。

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本文引用的文献

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Fatigue in stroke rehabilitation patients: a pilot study.中风康复患者的疲劳:一项初步研究。
Physiother Res Int. 2011 Sep;16(3):151-8. doi: 10.1002/pri.476. Epub 2010 May 18.
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HIV-associated opportunistic infections of the CNS.HIV 相关的中枢神经系统机会性感染。
Lancet Neurol. 2012 Jul;11(7):605-17. doi: 10.1016/S1474-4422(12)70098-4.
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Harnessing neuroplasticity for clinical applications.利用神经可塑性进行临床应用。
Brain. 2011 Jun;134(Pt 6):1591-609. doi: 10.1093/brain/awr039. Epub 2011 Apr 10.
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Pediatric stroke in an African country.一个非洲国家的小儿中风
J Pediatr Neurosci. 2010 Jan;5(1):22-4. doi: 10.4103/1817-1745.66676.
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Diabetes in sub-Saharan Africa.撒哈拉以南非洲的糖尿病问题。
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