Arendt G, Hefter H, Hilperath F, von Giesen H J, Strohmeyer G, Freund H J
Department of Neurology, Heinrich Heine University, Dusseldorf, Germany.
J Neurol Sci. 1994 May;123(1-2):180-5. doi: 10.1016/0022-510x(94)90221-6.
One hundred HIV-positive individuals without clinically evident central nervous system (CNS) deficits entered this follow-up study and were examined clinically and with a well-defined motor test battery every 3 months over 2 years or until they decreased. They underwent magnetic resonance tomography once a year. None received any form of therapy at onset of the study. Three groups were analyzed: (A) patients without electrophysiologically detectable motor impairment (n = 23), (B) patients with electrophysiologically detectable motor impairment but no virostatic medication (n = 33), and (C) patients with motor deficits undergoing AZT treatment (n = 44) after study onset. Group A patients, although slightly deteriorating over time, had the best clinical and electrophysiological outcome compared to the other groups, whereas group B patients deteriorated markedly in both clinical and electrophysiological tests, even though the majority did not develop cerebral complications during the observation period. Those group C patients belonging to early CDC stages (II and III) improved electrophysiologically under AZT therapy, while 76% of the patients in more advanced stages (CDC IVA-D) died of cerebral AIDS manifestations. Four patients of this group, being alive at the end of the study, were completely demented. It is suggested that early detectable motor impairment predicts future cerebral involvement in AIDS. Late onset of virostatic treatment did not influence the clinical outcome.
100名无明显中枢神经系统（CNS）缺陷的HIV阳性个体进入了这项随访研究，在2年的时间里每3个月接受一次临床检查，并使用一套明确的运动测试组合进行检测，直至病情恶化。他们每年接受一次磁共振断层扫描。研究开始时，无人接受任何形式的治疗。研究分析了三组：（A）无电生理可检测到的运动障碍患者（n = 23），（B）有可电生理检测到的运动障碍但未接受抗病毒药物治疗的患者（n = 33），以及（C）研究开始后接受齐多夫定（AZT）治疗的有运动缺陷的患者（n = 44）。A组患者尽管随着时间推移略有恶化，但与其他组相比，其临床和电生理结果最佳，而B组患者在临床和电生理测试中均明显恶化，尽管大多数患者在观察期内未发生脑部并发症。C组中处于疾病控制中心（CDC）早期阶段（II和III）的患者在接受AZT治疗后电生理状况有所改善，而处于更晚期阶段（CDC IVA - D）的患者中有76%死于脑部艾滋病表现。该组中有4名患者在研究结束时仍存活，但已完全痴呆。研究表明，早期可检测到的运动障碍可预测艾滋病患者未来的脑部受累情况。抗病毒治疗的延迟开始并未影响临床结果。
