摘要
目的:观察高效抗逆转录病毒治疗AIDS伴有严重血小板低下的临床疗效。方法:选取某院2016年4月~2017年9月间收治的50例HIV/AIDS患者作为研究对象,以其中使用高效抗逆转录病毒治疗的30例患者建立观察组,以由于各种原因无法行艾滋病高效抗病毒治疗的20例患者建立对照组,观察患者的血小板计数、HIV-RNA载量以及CD4~+T淋巴细胞计数水平的变化情况。结果:20例对照组持续观察血小板、CD4~+T淋巴细胞计数未见显著差异。30例患者经治疗后,血小板、CD4~+T淋巴细胞计数均逐渐升高,而HIV-RNA载量水平则逐渐降低。治疗前与治疗后1个月、6个月患者血小板、CD4~+T淋巴细胞计数均存在显著差异(P<0.05);30例患者治疗前HIV-RNA载量(2064027.32±602529.44)copies/mL,治疗6个月后21例(70.0%)HIV-RNA载量<40.00copies/mL,其余9例有不同程度下降;治疗1年后27例(90.0%)HIV-RNA载量<40.00copies/mL。结论:AIDS相关血小板计数减少与CD4细胞水平有密切关系,临床可通过检测患者的血小板计数以判断其CD4细胞水平,从而预测患者免疫功能的变化及病情的发展情况。通过对AIDS合并血小板减少患者予以高效抗逆转录病毒治疗能有效改善重度血小板减少的症状。
Objective:To observe the clinical efficacy of highly active antiretroviral therapy in the treatment of AIDS with severe thrombocytopenia.Methods:50 patients with HIV/AIDS in a hospital from April 2016 to September 2017 were selected.The observation group was established with 30 patients who received highly active antiretroviral therapy.The control group was established with 20 patients who could not receive high effective antiretroviral therapy for various reasons.The changes of platelet count,HIV-RNA load and CD4~+T lymphocyte count were observed.Results:There was no significant difference in platelet count and CD4~+T lymphocyte count between 20 control groups.After treatment,platelet and CD4~+T lymphocyte counts increased gradually,while HIV-RNA load decreased gradually.There were significant differences in platelet and CD4~+T lymphocyte counts before treatment and 1 month and 6 months after treatment(P<0.05);30 patients had HIV-RNA load(2064027.32±602529.44)copies/mL before treatment,and 21 patients(70.0%)had HIV-RNA load<40.00 copies/mL after 6 months of treatment,and the remaining 9 patients had a different degree of decrease.There were 27 cases(90.0%)with HIV-RNA load<40.00 copies/mL 1 year after treatment.Conclusion:AIDS-related thrombocytopenia is closely related to the level of CD4 cells.The level of CD4 cells can be judged by detecting the platelet count of patients in clinic,so as to predict the changes of immune function and the development of the disease.Efficient antiretroviral therapy can effectively improve the symptoms of severe thrombocytopenia in AIDS patients with thrombocytopenia.
引文
1 韦静彬,温小凤,蒋忠胜.高效抗逆转录病毒治疗艾滋病的生存时间及临床疗效观察.基层医学论坛,2017,21(13):1645~1647.
2 何伶俐,陈竹,王嘉川.25例以血小板减少为主的HIV/AIDS患者病例分析.泰州职业技术学院学报,2016,16(2):65~68.
3 包青龙.高效抗反转录病毒治疗艾滋病患者的临床疗效及不良反应观察.当代医学,2016,22(6):40~41.