【摘要】 目的 探讨绵阳地区HIV/AIDS患者肝损伤状况及影响因素，为早期发现HIV/AIDS患者肝损伤提供依据。方法 采用便利抽样法于2019年2月—2021年7月抽取绵阳市某医院761例HIV/AIDS门诊患者进行回顾性研究，所有患者均接受抗逆转录病毒疗法(antiretroviral therapy, ART),收集其性别、年龄、静脉注射毒品史、疾病史、实验室指标等一般资料，随访1年，统计其治疗过程中肝损伤的发生情况，不同特征HIV/AIDS患者肝损伤患病情况采用χ~2检验，采用多因素logistic回归分析肝损伤发生的独立危险因素。结果 761例HIV/AIDS患者中，肝功能损伤132例，患病率为17.35%,1～2级肝损伤占81.82%,3～4级肝损伤占18.18%;多因素logistic回归分析结果显示，年龄增加(OR=4.435,95%CI:2.372～6.237)、HIV病毒载量高(OR=6.528,95%CI:4.778～9.465)、HIV感染时间长(OR=8.516,95%CI:5.527～11.256)、HBsAg~+(OR=12.456,95%CI:7.683～15.328)、HCV-Ab~+(OR=9.742,95%CI:6.659～13.595)、CD4~+T淋巴细胞计数下降(OR=10.568,95%CI:8.238～12.752)、服用奈韦拉平(nevirapine, NVP)(OR=9.177,95%CI:4.271～14.538)均是增加HIV/AIDS患者肝损伤的危险因素(均P<0.05)。结论 绵阳地区HIV/AIDS患者存在以1～2级为主的轻度肝损伤，其发生受多种因素影响。临床可针对具体因素制定综合治疗方案，以防止肝损伤进一步加重，从而降低疾病死亡率。更多还原

【Abstract】 Objective To investigate the status and influencing factors of liver injury in HIV/AIDS patients in Mianyang Area, so as to provide a basis for the early detection of liver injury in these patients.Methods A retrospective study was conducted on 761 HIV/AIDS outpatients from a hospital in Mianyang, sampled from February 2019 to July 2021 by convenience sample method.All patients received antiretroviral therapy(ART).Collect general data on their sex, age, history of intravenous drug use, history of disease, and laboratory indicators were collected.Patients were followed for one year to count the incidence of liver injury during their treatments.The incidence of liver injury in HIV/AIDS patients with different characteristics was analyzed by χ~2,and the independent risk factors of liver injury were analyzed by mltifactorial logistic regression.Results Among the 761 HIV/AIDS patients, 132 cases had liver function injury, with a prevalence rate of 17.35%.Of these, grade 1-2 liver injury accounted for 81.82%,and grade 3-4 liver injury for 18.18%.Mltifactorial logistic regression analysis showed that increased age(OR=4.435,95%CI:2.372-6.237),high HIV viral load(OR=6.528,95%CI:4.778-9.465),longer duration of HIV infection(OR=8.516,95%CI:5.527-11.256),HBsAg~+(OR=12.456,95%CI:7.683-15.328),HCV-Ab~+(OR=9.742,95%CI:6.659-13.595),decreased CD4~+T lymphocyte count(OR=10.568,95%CI:8.238-12.752),and use of nevirapine(NVP)(OR=9.177,95%CI:4.271-14.538) were all risk factors for increased liver injury in HIV/AIDS patients(all P<0.05).Conclusion HIV/AIDS patients in Mianyang Area primarily experience mild liver injury of grade 1-2,influenced by various factors.Comprehensive clinical strategies should be developed according to specific factors to prevent further aggravation of liver injury and reduce disease mortality.更多还原