艾滋病患者抗病毒治疗前后睡眠质量变化分析
|
摘要
目的了解艾滋病患者睡眠障碍的发生率及抗病毒治疗期间睡眠质量的变化,以及睡眠质量对抗病毒治疗后免疫学应答及病毒学应答的影响。方法随机抽取新确诊的HIV感染患者54例,进行匹兹堡睡眠质量指数调查,并进行抗病毒治疗,随诊观察半年,分析治疗前、治疗3个月、治疗半年的睡眠质量,分析治疗前血浆病毒载量与睡眠质量的关系,以及睡眠质量对免疫学和病毒学应答的影响。结果 4例失访,50例完成随访。完成随访的50例患者中,抗病毒治疗(ART)前、ART 3个月、ART 6个月分别有30例(占60%)、21例(占42%)、19例(占38%)患者存在睡眠问题。ART 3月、ART 6个月睡眠质量指数与ART前相比显著下降(P <0.05)。基线HIV病毒载量> 1.0×105拷贝/ml的患者的PSQI评分(10.67±4.50分)显著高于基线HIV病毒载量≤1.0×10~5的患者(6.53±3.93)(t=2.747,P=0.009),在病毒载量> 1.0×10~5拷贝/ml的患者中,睡眠障碍发生率达88.9%。睡眠质量指数> 5分组与≤5分组相比,ART6个月后免疫学及病毒学应答无显著差异。结论 HIV感染者睡眠障碍发生率较高,特别是在病毒载量> 1.0×10~5拷贝/ml的患者中。抗病毒治疗后睡眠障碍的比例减少。应该重点关注治疗前HIV病毒载量较高患者的睡眠问题,及时给予抗病毒治疗及关怀。
Objective To evaluate the prevalence and the change of sleep quality in HIV-infected patients before and after antiretroviral therapy, and the effects of sleep quality on immunological and virological responses after antiviral therapy were also discussed. Methods A total of 54 HIV-infected patients were randomly selected for questionnaire of Pittsburgh Sleep Quality Index and antiviral treatment. Sleep quality was observed for six months. Sleep quality before treatment, three months after treatment and six months after treatment was analyzed. The relationship between plasma viral load and sleep quality before treatment was analyzed. The influence of sleep quality on immunological and virological responses was also analyzed. Results 50 cases were completed the follow-up, and 4 cases lost. The patients with sleep disturbance was 30(60%) before ART、21(42%)after 3 months ART and 19(38%) after 6 months ART. The prevalence of sleep disturbance was statistically higher before ART than those treated for 3 months and 6 months( P < 0.05).The baseline PSQI score was statistically higher in those with HIV viral load > 1.0×10~5 copies/ml(10.67±4.50) than those with HIV viral load < 1.0×10~5 copies/ml(6.53±3.93)(t=2.747,P=0.009). The incidence of sleep disturbance rate was 88.9% in those with HIV viral load > 1.0×10~5 copies/ml. In the group with PSQI score > 5 compared with the group which PSQI score ≤ 5, there was no significant difference between them in immunological and virological responses after ART for 6 months. Conclusion The prevalence of sleep disorders among people infected with HIV was high, particularly in those with HIV viral load > 1.0×10~5 copies/ml before ART. We should give more care about their sleep disturbance.
Objective To evaluate the prevalence and the change of sleep quality in HIV-infected patients before and after antiretroviral therapy, and the effects of sleep quality on immunological and virological responses after antiviral therapy were also discussed. Methods A total of 54 HIV-infected patients were randomly selected for questionnaire of Pittsburgh Sleep Quality Index and antiviral treatment. Sleep quality was observed for six months. Sleep quality before treatment, three months after treatment and six months after treatment was analyzed. The relationship between plasma viral load and sleep quality before treatment was analyzed. The influence of sleep quality on immunological and virological responses was also analyzed. Results 50 cases were completed the follow-up, and 4 cases lost. The patients with sleep disturbance was 30(60%) before ART、21(42%)after 3 months ART and 19(38%) after 6 months ART. The prevalence of sleep disturbance was statistically higher before ART than those treated for 3 months and 6 months( P < 0.05).The baseline PSQI score was statistically higher in those with HIV viral load > 1.0×10~5 copies/ml(10.67±4.50) than those with HIV viral load < 1.0×10~5 copies/ml(6.53±3.93)(t=2.747,P=0.009). The incidence of sleep disturbance rate was 88.9% in those with HIV viral load > 1.0×10~5 copies/ml. In the group with PSQI score > 5 compared with the group which PSQI score ≤ 5, there was no significant difference between them in immunological and virological responses after ART for 6 months. Conclusion The prevalence of sleep disorders among people infected with HIV was high, particularly in those with HIV viral load > 1.0×10~5 copies/ml before ART. We should give more care about their sleep disturbance.
引文
[1]中华医学会感染病学分会艾滋病学组.艾滋病诊疗指南第3版(2015版)[J].中华临床感染病杂志,2015,8(5):385-401.
[2]刘扬华,刘诗翔.睡眠障碍的诊断及治疗概述[J].神经损伤与功能重建,2012,7(2):143-146.
[3]Toma S,Omonuwa,Harold W,et al.The pharmacologic management of insomnia in patients with HIV[J].Journal of clinical sleep medicine:JCSM:official publication of the American Academy of Sleep Medicine,2009,5(3):251-62.
[4]蔡琳,何盛华,周锐峰,等.人类免疫缺陷病毒-1感染者血浆病毒载量与睡眠质量分析[J].中华传染病杂志,2015,33(4):231-233.
[5]Yinghui Low,Harold Goforth,Xavier Preud’ homme,et al.nsomnia in HIV-infected Patients:Pathophysiologic Implications[J].AIDSRev,2014(16):3-13.
[6]宋兵,秦玉玲,吴丹,等.抗病毒治疗初期HIV/AIDS患者睡眠质量影响因素分析[J].中华保健医学杂志,2018,20(4):321-323.
[7]Xiaojie Huang,Huiqin Li,Kathrine Meyers,et al.Burden of sleep disturbances and associated risk factors:A crosssectional survey among HIV-infected persons on antiretroviral therapy across China[J].Scientific Repo Rts,2017,DOI:10.1038/s41598-017-03968-3.
[8]Clotilde,Allavena,Thomas,et al.Prevalence and risk factors of sleep disturbances in a large HIV-infected adult population[J].Journal of the International AIDS Society,2014,17(4 Suppl 3):19576.
[2]刘扬华,刘诗翔.睡眠障碍的诊断及治疗概述[J].神经损伤与功能重建,2012,7(2):143-146.
[3]Toma S,Omonuwa,Harold W,et al.The pharmacologic management of insomnia in patients with HIV[J].Journal of clinical sleep medicine:JCSM:official publication of the American Academy of Sleep Medicine,2009,5(3):251-62.
[4]蔡琳,何盛华,周锐峰,等.人类免疫缺陷病毒-1感染者血浆病毒载量与睡眠质量分析[J].中华传染病杂志,2015,33(4):231-233.
[5]Yinghui Low,Harold Goforth,Xavier Preud’ homme,et al.nsomnia in HIV-infected Patients:Pathophysiologic Implications[J].AIDSRev,2014(16):3-13.
[6]宋兵,秦玉玲,吴丹,等.抗病毒治疗初期HIV/AIDS患者睡眠质量影响因素分析[J].中华保健医学杂志,2018,20(4):321-323.
[7]Xiaojie Huang,Huiqin Li,Kathrine Meyers,et al.Burden of sleep disturbances and associated risk factors:A crosssectional survey among HIV-infected persons on antiretroviral therapy across China[J].Scientific Repo Rts,2017,DOI:10.1038/s41598-017-03968-3.
[8]Clotilde,Allavena,Thomas,et al.Prevalence and risk factors of sleep disturbances in a large HIV-infected adult population[J].Journal of the International AIDS Society,2014,17(4 Suppl 3):19576.