女性艾滋病患者接受奈韦拉平抗病毒治疗方案致肝毒性的临床观察

目的探讨女性艾滋病患者在CD4+T淋巴细胞计数≥250个/μl时使用奈韦拉平(NVP)抗病毒治疗方案是否会增加肝毒性。方法选取女性艾滋患者158例,其中CD4+T淋巴细胞计数≥250个/μl者86例设为高CD4+组,CD4+T淋巴细胞计数<250个/μl者72例设为低CD4+组。分别于治疗前、治疗后1个月、2个月、3个月、6个月、9个月、12个月检测肝功能、血常规、CD4+T淋巴细胞等,分析2组患者3个月内的肝功能变化,并观察2组肝损害程度。结果低CD4+组治疗后(1个月、2个月、3个月)ALT水平均高于治疗前,差异均有统计学意义(P<0.05);高CD4+组患者治疗后(1个月、2个月)ALT水平均高于治疗前,差异均有统计学意义(P<0.05)。2组患者治疗后(1个月、2个月、3个月)TBIL水平均高于治疗前,差异均有统计学意义(P<0.05)。2组治疗后肝损害程度明显增加(P<0.05),且2组治疗后比较差异无统计学意义(P>0.05)。结论高效抗逆转录病毒治疗中奈韦拉平发生肝毒性较常见,女性艾滋病患者CD4+T淋巴细胞计数≥250个/μl时使用含有奈韦拉平的治疗方案未增加肝毒性。

The clinical observation of hepatotoxicity in female patient with AIDS received nevirapine antiretroviral therapy

Objective To discuss whether or not to add the hepatotoxicity in female patient with AIDS received nevirapine（NVP） antiretroviral therapy when the count of the CD4＋ T lymphocyte ≥250 cells/μl.Methods Choosed 158 cases female AIDS patients,86 cases with the count of the CD4＋ T lymphocyte ≥250 cells/μl were defined as the high CD4＋ group;72 cases with the count of the CD4＋ T lymphocyte 250 cells/μl were defined as the low CD4＋ group.Respectively,before treatment,after 1 month,2 months,3 months,6 months,9 months,12 months,checked liver function,blood routine,CD4＋ T lymphocytes,analysed liver function of two groups within 3 months and observed the liver damage in two groups.Results After treatment（1 month,2 months,3 months）,the ALT level of low CD4＋ group were higher than that before treatment（P0.05）;After treatment（1 month,2 months）,the ALT level of high CD4＋ group were higher than that pre-treatment（P0.05）.After treatment（1 month,2 months,3 months）,the TBIL level of two groups were higher than that before treatment（P0.05）.After treatment,the degree of liver damage of two groups significantly increased（P0.05）;And compared with the degree of liver damage of two groups after treatment,the difference was not statistically significant（P0.05）.Conclusion It＇s usual to causes hepatotoxicity of NVP in highly active antiretroviral treatment.The female AIDS patients with the count of the CD4＋ T lymphocyte ≥250 cells/μl can use NVP,not obvious increase of hepatotoxicity.