血栓弹力图评估高效抗反转录病毒治疗吸毒人群艾滋病患者的凝血功能
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摘要
目的利用血栓弹力图(TEG)评估HAART吸毒人群艾滋病患者的凝血功能。方法选取70例戒毒所在押的吸毒人群艾滋病患者作为观察组,并按照是否HAART分为治疗组(29例)和未治疗组(41例),同时选取46例未感染艾滋病的吸毒人群作为对照组。采用调查问卷收集患者基础资料。所有受试者统一进行TEG、传统凝血功能检测(CCT)、Plt、HCV-IgG检测。结果 1)治疗组MA值明显高于未治疗组[(54.80±6.11)mm vs(50.82±8.52)mm,P<0.05];2)治疗组与未治疗组比较R值、K值、a角、CI值;CCT7项指标(PT、INR、APTT、TT、FIB、D-D、AT)及Plt[(176.66±70.04)×10~9/L vs(170.59±60.58)×10~9/L]无差异(P>0.05);3)治疗组和未治疗组与对照组比较R值缩短[(5.99±2.28)min、(6.55±1.54)min vs(7.51±1.30) min]、MA值降低[(54.80±6.11)mm、(50.82±8.52)mm vs(58.38±4.31)mm];PT、INR、TT延长,AT降低;Plt降低,差异均有统计学意义(P<0.05)。结论利用TEG可有效地揭示HAART吸毒人群艾滋病患者凝血功能的细微变化,且比CCT更具优势。HAART可显著提升患者的血小板功能。
Objective To evaluate the coagulation function through thromboelastography(TEG) in highly active antiretroviral therapy(HARRT) treated AIDS patients who were drug users. Methods Seventy AIDS patients who were drug users in a drug rehabilitation center were enrolled into this study and classified into treatment group(29 cases)and non-treated group(41 cases) according to the receiving of HARRT intervention or not. Another 46 drug users without AIDS was selected as the control group.The demographic data of above patients was investigated by filling the questionnaires and such clinical index as TEG, CCT, Plt and HCV-IgG of them were all tested. Results 1) The MA value(mm) in the treatment group was significantly higher than that in the non-treated group[(54.80±6.11) vs.(50.82±8.52),P<0.05]; 2)No significant difference in the R value, K value, α angle, CI value, seven CCT indicators(PT, INR, APTT, TT, FIB, D-D, and AT) and Plt level was found between treatment group and non-treated group(P>0.05); 3)The R value(min) [(5.99±2.28),(6.55±1.54)vs.(7.51±1.30) ] and MA value(mm) [(54.80±6.11),(50.82±8.52)vs.(58.38±4.31)] in the treatment or non-treated group was lower than that of the control group;Plt and AT in the treatment and non-treated group decreased, and PT, INR and TT were prolonged(P<0.05). Conclusion Subtle changes of coagulation function in HARRT treated drug users with AIDS can be effectively revealed using TEG, which is more advantageous than CCT. HAART can significantly improve the PLT function of patients..
Objective To evaluate the coagulation function through thromboelastography(TEG) in highly active antiretroviral therapy(HARRT) treated AIDS patients who were drug users. Methods Seventy AIDS patients who were drug users in a drug rehabilitation center were enrolled into this study and classified into treatment group(29 cases)and non-treated group(41 cases) according to the receiving of HARRT intervention or not. Another 46 drug users without AIDS was selected as the control group.The demographic data of above patients was investigated by filling the questionnaires and such clinical index as TEG, CCT, Plt and HCV-IgG of them were all tested. Results 1) The MA value(mm) in the treatment group was significantly higher than that in the non-treated group[(54.80±6.11) vs.(50.82±8.52),P<0.05]; 2)No significant difference in the R value, K value, α angle, CI value, seven CCT indicators(PT, INR, APTT, TT, FIB, D-D, and AT) and Plt level was found between treatment group and non-treated group(P>0.05); 3)The R value(min) [(5.99±2.28),(6.55±1.54)vs.(7.51±1.30) ] and MA value(mm) [(54.80±6.11),(50.82±8.52)vs.(58.38±4.31)] in the treatment or non-treated group was lower than that of the control group;Plt and AT in the treatment and non-treated group decreased, and PT, INR and TT were prolonged(P<0.05). Conclusion Subtle changes of coagulation function in HARRT treated drug users with AIDS can be effectively revealed using TEG, which is more advantageous than CCT. HAART can significantly improve the PLT function of patients..
引文
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[2] 赵平森,钟志雄,曾沛斌,等.梅州市HIV/AIDS患者接受HAART后CD4+T淋巴细胞变化.中国输血杂志,2016,29(7):675-678.
[3] 吕青,荣维江.AIDS患者凝血功能检测的临床探索.中国医药指南,2014,12(24):24-25.
[4] 杨小兵.AIDS患者凝血功能检测的临床意义.中国误诊学杂志,2009,9(9):2100.
[5] Haugaard AK,Lund TT,Birch C,et al.Discrepant coagulation profile in HIV infection:elevated D-dimer but impaired platelet aggregation and clot initiation.AIDS,2013,27(13):2749-2758.
[6] 简长春,陈诚,戴浈浈,等.血栓弹力图评价关节置换术围手术期凝血功能改变.重庆医科大学学报,2015,40(5):770-773.
[7] 翟晶,梅静远,宋丽军,等.云南省2013年吸毒人群艾滋病行为调查分析.中华疾病控制杂志,2015,19(4):364-366.
[8] 赵金仙,马丽,李顺祥,等.静脉吸毒人群HIV/HCV感染患者肝功能分析.预防医学情报杂志,2010,26(2):121-123.
[9] 孙亮,林茂锐,陈丹霞,等.311例海洛因依赖者嗜肝病毒阴性ALT分析.现代医院,2008,11(8):50-52.
[10] 陈谐捷,李凌华,唐小平,等.HIV/AIDS患者合并HCV感染对HAART不良反应的影响.中国艾滋病性病,2012,18(3):141-144.
[11] 岳枫,李长峰,朱长波.吸毒患者血栓弹力图与ALT的相关性研究.中国输血杂志,2016,29(5):486-488.
[12] 严敏主编.围手术期合理输血.北京:人民卫生出版社,2014:53-55,435-436.
[13] Satchell CS,Cotter AG,O′Connor EF,et al.Platelet function and HIV:a case-control study.AIDS (London,England) 2010,24:649-657.
[14] 刘翠娥,计云霞,王玉江,等.以腔口出血为首发症状的艾滋病临床分析.中国艾滋病性病,2010,16(4):417-418.
[2] 赵平森,钟志雄,曾沛斌,等.梅州市HIV/AIDS患者接受HAART后CD4+T淋巴细胞变化.中国输血杂志,2016,29(7):675-678.
[3] 吕青,荣维江.AIDS患者凝血功能检测的临床探索.中国医药指南,2014,12(24):24-25.
[4] 杨小兵.AIDS患者凝血功能检测的临床意义.中国误诊学杂志,2009,9(9):2100.
[5] Haugaard AK,Lund TT,Birch C,et al.Discrepant coagulation profile in HIV infection:elevated D-dimer but impaired platelet aggregation and clot initiation.AIDS,2013,27(13):2749-2758.
[6] 简长春,陈诚,戴浈浈,等.血栓弹力图评价关节置换术围手术期凝血功能改变.重庆医科大学学报,2015,40(5):770-773.
[7] 翟晶,梅静远,宋丽军,等.云南省2013年吸毒人群艾滋病行为调查分析.中华疾病控制杂志,2015,19(4):364-366.
[8] 赵金仙,马丽,李顺祥,等.静脉吸毒人群HIV/HCV感染患者肝功能分析.预防医学情报杂志,2010,26(2):121-123.
[9] 孙亮,林茂锐,陈丹霞,等.311例海洛因依赖者嗜肝病毒阴性ALT分析.现代医院,2008,11(8):50-52.
[10] 陈谐捷,李凌华,唐小平,等.HIV/AIDS患者合并HCV感染对HAART不良反应的影响.中国艾滋病性病,2012,18(3):141-144.
[11] 岳枫,李长峰,朱长波.吸毒患者血栓弹力图与ALT的相关性研究.中国输血杂志,2016,29(5):486-488.
[12] 严敏主编.围手术期合理输血.北京:人民卫生出版社,2014:53-55,435-436.
[13] Satchell CS,Cotter AG,O′Connor EF,et al.Platelet function and HIV:a case-control study.AIDS (London,England) 2010,24:649-657.
[14] 刘翠娥,计云霞,王玉江,等.以腔口出血为首发症状的艾滋病临床分析.中国艾滋病性病,2010,16(4):417-418.