摘要
目的探讨HIV/AIDS患者在联合抗反转录病毒治疗后不同免疫应答状态下消化道症状的差别并分析其影响因素,为HIV/AIDS患者抗病毒治疗后的免疫重建和病情控制提供参考依据。方法利用查阅病历资料、发放问卷调查等方式对解放军总医院第五医学中心2021年1月至2024年1月病房收治与门诊接诊的229例HIV/AIDS患者的一般及临床资料进行回顾性分析。所有患者均经过2年及以上的联合抗反转录病毒治疗,按照患者免疫应答状态的不同进行分组,比较其出现消化道症状的差别并分析影响因素。结果229例患者中存在消化道症状者68例,占比29.69%,其中免疫应答患者、不完全免疫应答患者和免疫无应答患者出现消化道症状的比例分别为31.19%、20.51%和32.10%,3组中最常见的症状均为腹痛腹泻,占比分别为19.27%、7.69%和17.28%,Logistic多因素分析发现性别为男性、感染途径为同性性接触传播、CD4/CD8比值倒置是患者出现消化道症状的促进因素。结论HIV/AIDS患者经联合抗反转录病毒治疗后消化道症状仍然常见,其中腹痛腹泻出现的比例最高,该类症状的存在可能与患者性别、感染途径、CD4/CD8比值有关。因此,HIV/AIDS患者抗病毒治疗后仍应继续关注患者的消化道症状表现并及时处理,定期监测其CD4^(+)T细胞计数、CD4/CD8比值水平,对于控制消化道病变及其他HIV/AIDS相关并发症、延缓患者病情发展具有重要的临床意义。
Objective To investigate the difference of gastrointestinal symptoms in HIV/AIDS patients with different immune responses after combined antiretroviral therapy and analyze its influencing factors,so as to provide reference for immune reestablishment and disease control in HIV/AIDS patients after antiviral therapy.Methods The general and clinical data of 229 HIV/AIDS patients admitted and treated in the ward and outpatient department of Fifth Medical Center of PLA General Hospital from January 2021 to January 2024 were retrospectively analyzed by means of medical records and questionnaires.After 2 years or more of combined antiretroviral therapy,all patients were divided into groups according to their immune response status,and the differences in gastrointestinal symptoms were compared and the influencing factors were analyzed.Results Among the 229 patients,68 cases(29.69%)had digestive tract symptoms,among which the proportions of immune response patients,incomplete immune response patients and immune non-response patients were 31.19%,20.51%and 32.10%,respectively.The most common symptom in the 3 groups was abdominal pain and diarrhea.The proportion was 19.27%,7.69%and 17.28%,respectively.Logistic multivariate analysis found that gender being male,infection route being homosexual transmission.Conclusions Gastrointestinal symptoms are still common in HIV/AIDS patients after combined antiretroviral therapy,and the proportion of abdominal pain and diarrhea is the highest.The existence of such symptoms may be related to the gender of patients,infection route and CD4/CD8 ratio.Therefore,after antiviral treatment,patients with HIV/AIDS should continue to pay attention to their gastrointestinal symptoms and timely treatment,and regularly monitor their CD4^(+)T cell and CD4/CD8 ratio levels,which is of important clinical significance for controlling digestive tract lesions and other HIV/AIDS-related complications and delaying the development of patien ts’disease.
作者
潘月飞
王泽瑞
李雪萌
费竹轩
焦艳梅
石磊
王福生
PAN Yuefei;WANG Zerui;LI Xuemeng;FEI Zhuxuan;JIAO Yanmei;SHI Lei;WANG Fusheng(Department of Infectious Disease Medicine,Fifth Medical Center,PLA General Hospital,National Clinical Research Center of Infectious Diseases,Beijing 10039,China)
出处
《传染病信息》
2024年第4期289-293,298,共6页
Infectious Disease Information
基金
国家自然科学基金(82272317)。
作者简介
通信作者:王福生,E-mail:fsWang302@163.com。
