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目的了解高效抗逆转录病毒治疗(HAART)临床毒副作用及疗效的动态变化情况。方法分析2011年4-8月昆明市第三人民医院门诊初治艾滋病患者的背景资料、实验室检查、临床毒副作用、治疗方案变更情况。结果共入组73例,16例(21.92%)出现临床毒副作用,29例(39.73%)合并肝炎病毒。最常见的临床毒副作用为骨髓抑制(12.33%),其次为肝毒性(10.96%)、药疹(5.48%)、末梢神经炎(5.48%)、乳酸酸中毒(1.37%,死亡)和脂肪萎缩(1.37%)。随着年龄增大,临床毒副作用发生率越高。CD4+T淋巴细胞数计数分别在0~6月、6~12月和12~24月平均上升94.0cell/μL、44.3cell/μL和34.7cell/μL。静脉吸毒的艾滋病患者治疗后CD4+T淋巴细胞计数上升幅度小于其他传播途径的患者。结论接受HAART治疗的艾滋病患者临床毒副作用发生率高,是导致患者死亡的重要原因,需密切监测。
Objective To understand the clinical effect and side effect of HAART. Methods From April to August in 2011, the background information, laboratory tests, clinical toxicities and side effects of treatment-naive patients and the change of treatment regimen were analyzed in the outpatient AIDS-naive patients in Kunming Third People’s Hospital. Results A total of 73 patients were enrolled. Clinical side effects occurred in 16 patients (21.92%) and hepatitis virus in 29 patients (39.73%). The most common clinical side effects were myelosuppression (12.33%) followed by hepatotoxicity (10.96%), drug eruptions (5.48%), peripheral neuritis (5.48%), lactic acidosis (1.37%, deaths) and lipoatrophy %). With age, the higher the incidence of clinical side effects. The number of CD4 + T lymphocytes increased by 94.0cell / μL, 44.3cell / μL and 34.7cell / μL on average from June to June, from June to December and from December to April respectively. The number of CD4 + T lymphocytes in HIV-infected AIDS patients after treatment was less than that in other routes of transmission. Conclusion The high incidence of clinical side effects of AIDS patients receiving HAART treatment is an important cause of death in patients and needs to be closely monitored.