山西省闻喜县艾滋病患者抗病毒治疗的毒副反应

目的了解山西省农村地区艾滋病患者接受国家免费抗逆转录病毒治疗(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日纳入免费ART项目的 205例艾滋病患者进行研究,所有患者定期进行毒副反应临床和实验室评估。采用SPSS11.5软件进行统计分析,率的比较采用χ2检验,P0.05为差异有统计学意义。结果患者中位治疗时间为47.0个月。在治疗过程中,84.6%的患者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。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。针对NVP诱导的肝毒性和AZT诱导的贫血,在更换药物后,患者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,应保持对患者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。

Adverse effects of antiretroviral treatment among AIDS patients in Wenxi,Shanxi

Objective To determine the prevalence of adverse effects of antiretroviral treatment regimens among free treated rural AIDS patients in Shanxi province.Methods We observed the adverse events of 205 rural AIDS patients,who received Chinese Central Government sponsored free antiretroviral treatment（ART） between July 1st,2004 and December 1st,2009.The observations of adverse effects included clinical evaluation and laboratory testing.Results The adverse events of ART occurred in 84.6% of AIDS patients with either clinical or laboratory evaluation.Commonly occurred short-term adverse events included gastrointestinal toxicities（52.8%）,anemia（38.5%）,fatigue（30.3%）,rash（24.1%） and central nervous system（CNS） toxicity（16.4%）,and long-term adverse effects included hepatotoxicity（17.4%）,peripheral neurotoxicity（15.9%） and evaluated serum amylase（9.2%）,respectively.Anemia was most frequently observed with AZT treatment;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.The symptoms of liver toxicity and anemia could be reduced with alternative treatment with NVP and AZT.Conclusion The short and long term adverse events are common among ART AIDS patients.Some symptoms were frequently observed in certain drugs.Regular surveillance and adverse event treatment are essential for successful AIDS patient ART treatment.