摘要
目的：比较连续性血液净化和常规血液透析（hemodialysis, HD）治疗HIV/AIDS乳酸酸中毒的疗效。方法13例乳酸酸中毒HIV/AIDS患者中男2例，女11例，外周血乳酸水平为7.8（5.9～12.6）mmol/L，分别行连续性静脉-静脉血液过滤（continuous venovenous hemofiltration, CVVH）和HD治疗，并对二者的疗效进行比较。结果患者主要临床症状为疲乏无力、恶心呕吐、肌肉酸痛、体重下降和心动过速，其他症状为呼吸困难和四肢麻木。CVVH和HD治疗后30 min乳酸下降幅度分别为（32.3±5.5）%和（29.2±6.7）%，2组差异无统计学意义；治疗后24 h乳酸上升幅度分别为（24.1±5.2）%和（26.31±3.7）%，2组差异无统计学意义。结论 HIV/AIDS乳酸酸中毒患者采取长时间、多频次的HD治疗可达到降低乳酸和缓解临床症状的目的，同时能减少患者额外的经济负担。但由于例数较少，该研究中乳酸酸中毒的血液净化治疗还没有一个明确的时间窗口和乳酸靶目标值。
Objective To compare the therapeutic effects of continuous blood purification and conventional hemodialysis （HD） on lactic acidosis in HIV/AIDS patients. Methods Thirteen HIV/AIDS patients with lactic acidosis were enrolled in the study, of whom 2 were males and 11 females. The average level of peripheral blood lactic acid was 7.8 （5.9-12.6） mmol/L. The patients were given treatment with continuous veno-venous hemofiltration （CVVH） and HD respectively, and the therapeutic effects were com-pared. Results The main clinical symptoms were fatigue and weakness, nausea and vomiting, myalgia, weight loss and tachycardia, and other symptoms were shortness of breath and numbness in the limbs. The average levels of actic acid decreased by 32.31±5.5%and 29.2%±6.7%, respectively, after 30 minutes of treatment with CVVH and HD, and the difference between the two groups was not significant. The levels increased by 24.1%±5.2% and 26.3%±3.7%, respectively, after 24 hours of treatment with CVVH and HD, and the difference between the two groups was not significant. Conclusions Long-time and multifrequency HD can reduce lactic acid level and relieve symptoms in HIV/AIDS patients with lactic acidosis, while reducing the additional economic burden of the patients. Due to the fewer number of cases, it is hard to confirm time constraint and targeted level of lactic acid for blood purification treatment.
出处
《传染病信息》
2014年第3期170-173,共4页
Infectious Disease Information
基金
国家中医药管理局国家中医临床研究基地业务建设科研专项课题(JDZX2012163)
关键词
酸中毒
乳酸性
获得性免疫缺陷综合征
抗逆转录病毒治疗
高效
HIV
acidosis,lactic
acquired immunodeficiency syndrome
antiretroviral therapy,highly active
HIV
