【作者】 刘星； 乔晓春； 董少良； 杨清海； 卫军； 丁盈盈； 何纳；

【Author】 LIU Xing,QIAO Xiao-chun,DONG Shao-Hang,YANG Qing-hai,WEI Jun,DING Ying-ying~1,HE Na~1.1.School of Public Health,Fudan University,Key Laboratory of Public Health Safety,Ministry of Education,Shanghai 200032,China;2.Shanxi Center for Disease Control and Prevention, Taiyuan 030012,China;3.Wenxi Center for Disease Control and Prevention,Yuncheng 043800, China;4.Yuncheng Center for Disease Control and Prevention,Yuncheng 44000,China

【机构】 复旦大学公共卫生学院,教育部公共卫生安全重点实验室； 山西省疾病预防控制中心； 山西省闻喜县疾病预防控制中心； 山西省运城市疾病预防控制中心；

【摘要】 目的了解山西省农村地区艾滋病病人接受国家免费抗病毒治疗(ART)后毒副反应发生情况并分析其影响因素。方法对山西省闻喜县2004年7月1日至2009年12月1日期间纳入免费抗病毒治疗项目的艾滋病病人共205名进行研究分析,所有病人在治疗过程中按国家治疗方案要求定期进行毒副反应临床和实验室评估。结果病人中位治疗时间为47.0个月。在治疗过程中,84.6%的病人出现药物相关毒副反应,常见的短期毒副反应有消化系统症状(52.8%)、贫血(38.5%)、疲倦(30.3%)、皮疹(24.1%)和中枢神经系统症状(16.4%)等;中长期毒副反应有肝毒性(17.4%)、外周神经炎(15.9%)和血清淀粉酶升高(9.2%)等。本研究对特异性毒副反应的药物服用方案分析发现:ddI与消化系统症状,AZT与贫血,d4T、ddI和AZT与外周神经炎,NVP和EFV与皮疹和肝毒性,NVP与中枢神经系统毒性以及d4T与血清淀粉酶升高间有一定的特异关联。此外,针对NVP诱导的肝毒性和AZT诱导的贫血,在更换药物后,病人血液生化指标均恢复正常。结论抗病毒治疗开始后短期与长期内有不同的毒副反应谱,且有一定药物特异性,应保持对病人治疗不同阶段常见药物毒副反应的定期监测,及时采取相应措施。更多还原

【Abstract】 Objective To determine the prevalence and correlates of adverse effects of currently free antiretroviral treatment regimens for rural AIDS patients in Shanxi province.Methods A total of 205 AIDS patients in Wenxi county of Shanxi province who started antiretroviral treatment(ART) between July 1st,2004 and December 1st,2009 were included in the analysis.Clinical and laboratory evaluations of adverse effects were performed after the initiation of treatment.Results About 84.6%of patients presented with clinical and laboratory adverse events after receiving antiretroviral treatment.Commonly occurred short-term adverse effects included gastrointestinal toxicities(52.8%),anemia(38.5%), fatigue(30.3%),rash(24.1%) and toxicity of central nervous system(CNS)(16.4%);long-term adverse effects included hepatotoxicity(17.4%),peripheral neurotoxicity(15.9%) and elevated serum amylase(9.2%),respectively.Anemia was more likely to be associated with AZT,as well as gastrointestinal toxicities with ddI,peripheral neurotoxicity with d4T,ddI and AZT,hepatotoxicity and rash with NVP and EFV,CNS toxicity with NVP and elevated serum amylase with d4T.Liver toxicity or anemia was reducible by replacing NVP or AZT with alternative drugs.Conclusions Both short-term and long -term adverse effects are common among ART receiving AIDS patients in this rural area of central China. Some of the adverse effects are drug-specific.Regular surveillance and measures for adverse effects among ART receiving patients are essential.更多还原