获得性免疫缺陷综合征患者血脂和眼底动脉硬化的研究

目的 了解艾滋病患者血脂变化和视网膜动脉硬化的情况.方法 观察艾滋病患者高效抗逆转录病毒治疗(HAART)前后血脂变化和眼底动脉硬化情况,井与正常人进行比较.结果 观察25～35岁的艾滋病患者100例,其中未行HAART患者57例,已行HAART患者43例,同龄正常人45例.对观察对象行血脂和眼底检查,与正常人相比,未行HAART患者总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)、载脂蛋白AI、载脂蛋白B降低；已行HAART患者的TC升高,TG升高,载脂蛋白Al降低,载脂蛋白B升高.艾滋病患者的视网膜动脉硬化发生率高.已行HAART的43例患者中,有32例患者出现视网膜动脉硬化,占74.4％,以2级硬化为主(43.5％),而57例未行HAART的患者中有39例患者出现视网膜动脉硬化,占68.4％,以1级硬化为主(47.4％).结论 艾滋病患者有不同程度的血脂异常,在HAART治疗前,以TC、HDL-C、载脂蛋白Al、载脂蛋白B的降低为主;HAART治疗后,以TC、TG、载脂蛋白B的升高和载脂蛋白Al的降低为主.同时伴有不同程度的眼底动脉硬化.

Research on features of blood lipid and retinal arteriosclerosis in AIDS patients

Objective To investigate the features of blood lipid changes and retinal arteriosclerosis in acquired immunodeficiency syndrome（AIDS） patients. Methods The features of blood lipid changes and retinal arteriosclerosis in AIDS patients were observed before and after high~.y active antiretroviraI therapy（HAART） and were compared with those of normal persons. Results 100 cases of AIDS patients, age 25-35 years old, among which 57 cases before HAART and 4a cases after HAART were included, and 45 normal persons with the same age range were observed. Blood lipid examination and retinal arteriosclerosis examination were taken on all the subjects and comparisons were made between groups. Compared with those of normal persons, decreases of total cholesterol, high-density lipoprotein cholesterol,apolipoprotein A1, apolipoprotein B were detected on patients before HAART and increases of total cholesterol, triglyceride,apolipoprotein B, but decrease of apolipoprotein A1 were observed on patients aftei- H AART. However, retinal arteriosclerosis showed high incidence in AIDS patients. Among those 43 cases of AIDS patients after HAART,32 cases, accounting for 74.4%, were found with retinal arteriosclerosis and most of them were primarily with sclerosis of level 2 （43.5%）. However, among those 57 cases of AIDS patients before HAART, 32 cases, accounting for 68.4%, were found with retinal arteriosclerosis and most of them were primarily with sclerosis of level 1 （47.4%）. Conclusion Different levels of blood lipid abnormalities exist in A1DS patients. Decreases of total cholesterol,high-density lipoprotein cholesterol, apolipoprotein A1 and apolipoprotein B are predominant in patients before HAART. However, increases of total cholesterol, triglyceride, apolipoprotein B and decrease of apolipoprotein A1 are obvious in patients after HAART. And retinal arteriosclerosis with different degrees accompanies simultaneously.