發(fā)布時間：2018-04-28 21:40

  本文選題：抗逆轉(zhuǎn)錄病毒治療 + 高效　； 參考：《中華疾病控制雜志》2015年12期

【摘要】：目的探索含替諾福韋酯(tenofovir disoproxil fumarate,TDF)的高效抗逆轉(zhuǎn)錄病毒療法(highly active antiretroviral therapy,HAART)對抗逆轉(zhuǎn)錄病毒藥物初治HIV感染患者腎功能的影響。方法本研究回顧性分析TDF治療組和非TDF治療組、依非韋倫(efavirenz,EFV)治療組(即采用TDF+lamivudine(3TC)+EFV方案治療)和克力芝(lopinavir/ritonavir,LPV/RTV)治療組(即采用TDF+3TC+LPV/RTV方案治療)在CD4細(xì)胞計數(shù)和內(nèi)生肌酐清除率(rate of creatinine clearance,Cr Cl)上的差異。結(jié)果 TDF治療組和非TDF治療組患者的CD4細(xì)胞計數(shù)開始明顯升高的時間分別為12周和48周。TDF治療組患者在第24、48、60、72、84、96周時,Cr Cl比其基線時降低,差異具有統(tǒng)計學(xué)意義(均有P0.05),而非TDF治療組患者治療后,Cr Cl未出現(xiàn)明顯降低,無有統(tǒng)計學(xué)意義(均有P0.05)。EFV治療組和LPV/RTV治療組患者均從第12周起,CD4細(xì)胞計數(shù)升高,差異均有統(tǒng)計學(xué)意義(均有P0.05)。EFV治療組患者和LPV/RTV治療組患者的Cr Cl開始比其基線時降低的時間分別是72周和12周。結(jié)論在患者各項危險因素可控的情況下,推薦TDF+3TC+EFV為初治HIV患者的首選治療方案。
[Abstract]:Objective to investigate the effects of high active antiretroviral therapy with tenofovir disoproxil fumarate on renal function in patients with HIV infection. Methods the TDF treatment group and the non- treatment group were retrospectively analyzed in this study. The difference of CD4 cell count and creatinine clearance rate of creatinine clearance rate (Cr Cl) between the two groups (i.e., TDF lamivudine 3TC- EFV regimen) and lopinavirr / ritonavirr / ritonavirus-LPV-rRTV treatment group (i.e. TDF 3TC LPV/RTV regimen). Results the CD4 cell counts in the TDF treatment group and the non-TDF treatment group were significantly increased at 12 and 48 weeks, respectively. The CD4 cell counts in the TDF-treated group were significantly lower than those in the baseline group at the 24th week, 48th week, 6072U 84U, 96th week, respectively. The difference was statistically significant (P 0.05), but there was no significant decrease of Cr Cl in non-TDF treatment group (both P0.05).EFV treatment group and LPV/RTV treatment group increased CD4 cell count from the 12th week after treatment). There were significant differences between the two groups (the beginning time of the decrease of CRCL in P0.05).EFV group and LPV/RTV group was 72 weeks and 12 weeks, respectively). Conclusion under the condition of controllable risk factors, TDF 3TC EFV is recommended as the first choice of treatment for patients with HIV.
【作者單位】： 德宏州人民醫(yī)院感染科;芒市人民醫(yī)院感染科;德宏州第二人民醫(yī)院感染科;瑞麗市人民醫(yī)院感染科;隴川縣人民醫(yī)院感染科;盈江縣人民醫(yī)院感染科;梁河縣人民醫(yī)院感染科;
【基金】：“十二五”國家科技重大專項(2012ZX10001003-001)
【分類號】：R512.91

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