人类免疫缺陷病毒感染合并冠心病患者的临床特征分析
|
摘要
目的分析合并人类免疫缺陷病毒(HIV)感染的冠心病患者临床特征变化情况。方法选取2016年3月—2018年3月,于广州市第八人民医院心内科、感染科住院且诊断冠心病合并HIV感染者16例。根据入选患者性别、年龄(±1岁)选择16位非HIV感染的冠心病者为对照组。所有入选者住院期间均行冠状动脉造影检查明确冠心病诊断,且行心脏彩超检查。分析比较两组患者各项临床指标。结果两组患者间血红蛋白计数有差别(P <0. 05)。两组间比较在前降支及右冠状动脉血管狭窄程度上差别有统计差异(P <0. 05),回旋支血管病变程度差异无统计学意义。两组患者在冠脉血管病变支数上无差别,但合并HIV感染患者多支血管病变例数更多。合并HIV感染的冠心病者左室收缩功能受损。结论合并HIV感染的冠心病患者血红蛋白数更低,前降支及右冠状动脉血管的狭窄程度更严重,左室收缩功能下降。
Objective To analyze the clinical characteristics of patients with coronary heart disease complicated with HIV infection. Methods From March 2016 to March 2018,16 patients with coronary heart disease and HIV infection were hospitalized in the Department of Cardiology and Infectious Diseases of the Eighth People's Hospital of Guangzhou. Sixteen non-HIV-infected patients with coronary heart disease were selected as the control group according to their gender and age( ± 1 years). All patients underwent coronary angiography during hospitalization to confirm the diagnosis of coronary heart disease,and underwent color Doppler echocardiography. To analyze and compare the clinical indicators of patients with coronary heart disease complicated with HIV infection and non-HIV infection. Results There was a difference in hemoglobin count between the two groups( P < 0. 05). There were statistical differences in the degree of stenosis of the anterior descending branch and right coronary artery between the two groups( P < 0. 05),and there was no significant difference in the degree of atherosclerosis of the circumflex branch between the two groups. There was no difference in the number of coronary artery lesions between the two groups,but there were more cases of multi-vessel lesions in patients with HIV infection. Left ventricular systolic function was impaired in CHD patients with HIV infection. Conclusion Patients with coronary heart disease complicated with HIV infection had lower hemoglobin count and more severe stenosis of the anterior descending branch and right coronary artery,and left ventricular systolic function decreased.
Objective To analyze the clinical characteristics of patients with coronary heart disease complicated with HIV infection. Methods From March 2016 to March 2018,16 patients with coronary heart disease and HIV infection were hospitalized in the Department of Cardiology and Infectious Diseases of the Eighth People's Hospital of Guangzhou. Sixteen non-HIV-infected patients with coronary heart disease were selected as the control group according to their gender and age( ± 1 years). All patients underwent coronary angiography during hospitalization to confirm the diagnosis of coronary heart disease,and underwent color Doppler echocardiography. To analyze and compare the clinical indicators of patients with coronary heart disease complicated with HIV infection and non-HIV infection. Results There was a difference in hemoglobin count between the two groups( P < 0. 05). There were statistical differences in the degree of stenosis of the anterior descending branch and right coronary artery between the two groups( P < 0. 05),and there was no significant difference in the degree of atherosclerosis of the circumflex branch between the two groups. There was no difference in the number of coronary artery lesions between the two groups,but there were more cases of multi-vessel lesions in patients with HIV infection. Left ventricular systolic function was impaired in CHD patients with HIV infection. Conclusion Patients with coronary heart disease complicated with HIV infection had lower hemoglobin count and more severe stenosis of the anterior descending branch and right coronary artery,and left ventricular systolic function decreased.
引文
[1]WHO.World AIDS Day-1 December 2016[EB/OL].(2016-12-01)[2016-12-12].http://www.who.int/campaigns/aids-day/2016/event/en/.
[2]中华医学会感染病分会艾滋病组.中国人类免疫缺陷病毒感染的特殊群体抗病毒治疗专家共识[J].中华传染病杂志,2017,35(1):1-4.
[3]FREIBERG MS,CHANG CC,KULLER LH,et al.HIV infection and the risk of acute myocardial infarction[J].JAMA Intern Med,2013,173:614-622.
[4]TRIANT VA,LEE H,HADIGAN C,et al.Increased acute myocardial infarction rates and cardiovascular risk factors among patients with human immunodeficiency virus disease[J].J Clin Endocrinol Metab.2007,92:2506-2512.
[5]兰岭,张抒杨.人类免疫缺陷病毒感染者冠心病危险因素研究现况[J].中华心血管病杂志,2014,42(11):974-976.
[6]MILLS EJ,BARNIGHAUSEN T,NEGIN J,HIV and aging-preparing for the challenges[J].N Engl J Med,2012,366:1270-1273.
[7]吕明芳,薛凌,杨雪苹,等.急性心肌梗死并发心脏破裂患者近期死亡的临床特征分析[J].中国中西医结合急救杂志,2017,24(5):477-480.
[8]张琳琳,周玉杰,柴萌,等.早期绝经与女性冠心病研究进展[J].中华心血管病杂志,2014,42(8):706-708.
[9]孙桂元,蒋雅楠,张良栓,等.人类免疫缺陷病毒-反式转录激活激活因子蛋白在心血管疾病中的作用研究现状[J].中国临床药理学杂志,2016,32(18):1729-1732.
[10]吕明芳,薛凌,杨雪苹,等.急性心肌梗死合并不同部位心脏破裂的临床特征及预后[J].现代医院,2019,19(3):421-424.
[11]林转娣,周容佳,马闻华,等.社区综合干预对原发性高血压治疗效果的影响[J].岭南心血管病杂志,2012,18(5):521-524.
[12]田然,张抒杨.高效抗逆转录病毒治疗HIV感染者合并冠状动脉疾病研究现况[J].中华内科学杂志,2006,45(10):863-865.
[13]TABIB A,GREENLAND T,MERCIER I,et al.Coronary lesions in yong HIV-positive subjects at necropsy[J].Lancet,1992,340:730.
[14]BOCCARRA F,LANG S,MEULEMAN C,et,al.HIV and coronary heart disease:time for a better understanding[J].J Am Coll Cardiol,2013,61:511-523.
[15]LI Y,LI XH,YU ZX,et al.HIV protease inhibitors in pulmonary hypertension:rationale and design of a pilot trail in idiopathic pulmonary arterial hypertension[J].Pulm circ,2015,5(3):538-546.
[16]罗玲,李燕翎,等.人类免疫缺陷病毒感染者心脏收缩与舒张功能变化特点[J].中华传染病杂志,2017,35(6):348-351.
[2]中华医学会感染病分会艾滋病组.中国人类免疫缺陷病毒感染的特殊群体抗病毒治疗专家共识[J].中华传染病杂志,2017,35(1):1-4.
[3]FREIBERG MS,CHANG CC,KULLER LH,et al.HIV infection and the risk of acute myocardial infarction[J].JAMA Intern Med,2013,173:614-622.
[4]TRIANT VA,LEE H,HADIGAN C,et al.Increased acute myocardial infarction rates and cardiovascular risk factors among patients with human immunodeficiency virus disease[J].J Clin Endocrinol Metab.2007,92:2506-2512.
[5]兰岭,张抒杨.人类免疫缺陷病毒感染者冠心病危险因素研究现况[J].中华心血管病杂志,2014,42(11):974-976.
[6]MILLS EJ,BARNIGHAUSEN T,NEGIN J,HIV and aging-preparing for the challenges[J].N Engl J Med,2012,366:1270-1273.
[7]吕明芳,薛凌,杨雪苹,等.急性心肌梗死并发心脏破裂患者近期死亡的临床特征分析[J].中国中西医结合急救杂志,2017,24(5):477-480.
[8]张琳琳,周玉杰,柴萌,等.早期绝经与女性冠心病研究进展[J].中华心血管病杂志,2014,42(8):706-708.
[9]孙桂元,蒋雅楠,张良栓,等.人类免疫缺陷病毒-反式转录激活激活因子蛋白在心血管疾病中的作用研究现状[J].中国临床药理学杂志,2016,32(18):1729-1732.
[10]吕明芳,薛凌,杨雪苹,等.急性心肌梗死合并不同部位心脏破裂的临床特征及预后[J].现代医院,2019,19(3):421-424.
[11]林转娣,周容佳,马闻华,等.社区综合干预对原发性高血压治疗效果的影响[J].岭南心血管病杂志,2012,18(5):521-524.
[12]田然,张抒杨.高效抗逆转录病毒治疗HIV感染者合并冠状动脉疾病研究现况[J].中华内科学杂志,2006,45(10):863-865.
[13]TABIB A,GREENLAND T,MERCIER I,et al.Coronary lesions in yong HIV-positive subjects at necropsy[J].Lancet,1992,340:730.
[14]BOCCARRA F,LANG S,MEULEMAN C,et,al.HIV and coronary heart disease:time for a better understanding[J].J Am Coll Cardiol,2013,61:511-523.
[15]LI Y,LI XH,YU ZX,et al.HIV protease inhibitors in pulmonary hypertension:rationale and design of a pilot trail in idiopathic pulmonary arterial hypertension[J].Pulm circ,2015,5(3):538-546.
[16]罗玲,李燕翎,等.人类免疫缺陷病毒感染者心脏收缩与舒张功能变化特点[J].中华传染病杂志,2017,35(6):348-351.
© 2004-2018 中国地质图书馆版权所有 京ICP备05064691号 京公网安备11010802017129号 地址：北京市海淀区学院路29号 邮编：100083 电话：办公室：(+86 10)66554848；文献借阅、咨询服务、科技查新：66554700 |