|本期目录/Table of Contents|

[1]兰玲鲜,苏春雄,陈万,等.61 例慢性肾脏病维持透析的HIV/AIDS 患者血钙、血磷、全段甲状旁腺激素水平调查研究[J].传染病信息,2017,06:338-341.
 LAN Ling-xian,SU Chun-xiong,CHEN Wan,et al.Investigations on blood calcium, phosphorus, intact parathyroid hormone levelin 61 HIV/AIDS patients after chronic kidney disease maintenance hemodialysis[J].Infectious Disease Information,2017,06:338-341.
点击复制

61 例慢性肾脏病维持透析的HIV/AIDS 患者血钙、血磷、全段甲状旁腺激素水平调查研究(PDF)

《传染病信息》[ISSN:1007-8134/CN:11-3886/R]

期数:
2017年06期
页码:
338-341
栏目:
专题论著
出版日期:
2017-12-20

文章信息/Info

Title:
Investigations on blood calcium, phosphorus, intact parathyroid hormone levelin 61 HIV/AIDS patients after chronic kidney disease maintenance hemodialysis
作者:
兰玲鲜苏春雄陈万陈秋霞黄瑞芬郑卉梁纲
530023,广西艾滋病临床诊疗中心 南宁市第四人民医院血液净化科(兰玲鲜、苏春雄、陈秋霞、黄瑞芬、郑卉);530022 南宁, 广西医科大学病理生理教研室( 梁纲);530021 南宁,广西壮族自治区人民医院急诊ICU 病区(陈万)
Author(s):
LAN Ling-xian SU Chun-xiong CHEN Wan CHEN Qiu-xia HUANG Rui-fen ZHENG Hui LIANG Gang*
Department of Blood Purification, The Fourth People’s Hospital of Nanning, Guangxi AIDS Clinical Treatment Center, 530023, China
关键词:
HIV/AIDS慢性肾病矿物质代谢血液透析
Keywords:
HIV/AIDS chronic kidney disease mineral metabolism hemodialysis
分类号:
R589.5; R512.91
DOI:
10.3969/j.issn.1007-8134.2017.06.006
文献标识码:
A
摘要:
目的 了解广西地区维持性血液透析HIV/AIDS 患者矿物质代谢紊乱情况及可能相关影响因素。 方法 收集2011—2016 年在南宁市第四人民医院维持性血液透析3 个月及以上合并HIV 感染的61 例患者作为观察组,根据其治疗情况,分为高效抗反转录病毒治疗(highly active antiretroviral therapy, HAART ) 组(51 例)及非HAART 组(10 例),另选取30 例非HIV 感染维持血液透析大于3 个月患者作为对照组。检测患者血钙、血磷及全段甲状旁腺激素(inact parathyroidhormone, iPTH)等矿物质代谢的评估指标,并对相关影响因素进行探讨。 结果 观察组中,血钙、血磷、iPTH 的达标率分别为47.54%(29/61),24.59%(15/61)和21.31%(13/61);与对照组相比,在血钙、血磷、iPTH、HGB 及ALB 的平均值方面差异均有统计学意义(P 均< 0.05);在观察组中,HAART 患者血钙、iPTH 指标均高于非HAART 患者,血磷指标低于非HAART 患者(P 均< 0.05)。结论 广西地区维持性血液透析HIV/AIDS 患者矿物质代谢异常有其独特的临床表现,对于该人群的透析方式、HAART 方案、影响因素值得进一步研究。
Abstract:
Objective To investigate the mineral metabolism disorder and possible influencing factors in HIV/AIDS patientswith maintenance hemodialysis (MHD) in Guangxi area. Methods Sixty-one HIV/AIDS patients treated with MHD for more than 3months in the Fourth People’s Hospital of Nanning (Guangxi AIDS Clinical Treatment Center) from 2011 to 2016 were enrolled in thisstudy, and as the observation group, divided into 2 groups: highly active antiretroviral therapy (HAART) group (n=51) and non-HAARTgroup (n=10 cases). In addition, 30 non-HIV/AIDS patients treated with MHD for more than 3 months were selected as control group.The mineral metabolism indexes including blood calcium, phosphorus and intact varathvroid hormone (iPTH) were determined. Thenthe related influencing factors were explored. Results  Among the 61 HIV/AIDS patients, the control rate of blood calcium, serumphosphorus and iPTH was 47.54% (29/61), 24.59% (15/61) and 21.31% (13/61), respectively. Compared with the control group, the levelof blood calcium, phosphorus, iPTH, haemoglobin and ALB levels in the HIV group were significantly lower (P <0.05). However, thelevels of serum calcium and iPTH in the HAART group were higher than that in non-HAART group. Serum phosphorus in the HAARTgroup were lower than that in non-HAART group (P < 0.05). Conclusions HIV/AIDS patients in Guangxi area undergoing MHDtreatment exhibit unique clinical manifestations of abnormal mineral metabolism. The way of hemodialysis, HAART treatment programand its impact factor need further study.

参考文献/References

[1] 林向东,胡振奋,金霄,等. 188 例维持性血液透析患者治疗情况和骨矿物质代谢横断面调查报告[J]. 浙江医学,2014,36(24):2009-2011.
[2] 牛蒙,孙建平. 维持性血液透析患者钙磷代谢紊乱影响因素[J]. 山东医药,2014,54(41):101-103.
[3] 中华医学会感染病学分会艾滋病学组. 艾滋病诊疗指南(2011版)[J]. 中华临床感染病杂志,2011,4(6):321-330.
[4] National Kidney Foundation. K/DOQI clinical practice guidelinesfor bone metabolism and disease in chronic kidney disease[J].Am J Kidney Dis, 2003, 42(4 Suppl 3):SI-201.
[5] 王莉,李贵森,刘志红. 中华医学会肾脏病学分会《慢性肾脏病矿物质和骨异常诊治指导》[J]. 肾脏病与透析肾移植杂志,2013,22(6):554-559.
[6] 李文刚,赵敏. AIDS 抗病毒治疗研究进展[J]. 传染病信息,2013,26(4):247-250.
[7] Moe S, Drueke T, Cunningham J, et al. Definition, evaluation, andclassification of renal osteodystrophy: a position statement fromKidney Disease: Improving Global Out comes (KDIGO)[J].Kidney Int, 2006, 69(11):1945-1953.
[8] Tentori F, Blayney MJ, Albert JM, et al. Motrtality risk for dialysispatients with different levels of serum calcium, phosphorus andPTH: the dialysis outcomes and practice patterns study (DOPPS[) J].Am J Kidney Dis, 2008, 52(3):519-530.
[9] 黄维,黄葵,蓝珂,等. 10 例HIV/AIDS 患者HAART 后继发高乳酸血症或乳酸酸中毒临床分析[J].传染病信息,2012,25(6):367-369.
[10] 张璐,黎明,陶梅梅,等. 中国成人HIV 相关脂肪营养不良综合征55 例研究[J]. 中华内科杂志,2009,48(2):118-121.
[11] 陈怡,杨沁. 50 例艾滋病伴腹泻患者的营养状况分析[J].现代临床医学,2015,41(5):67-368,371.
[12] Buehring B, Kirchner E, Sun Z, et al. The frequency of lowmuscle mass and its overlap with low bone mineral density andlipodystrophy in individuals with HIV-a pilot study using DXAtotal body composition analysis[J].J Clin Densitom, 2012,15(2):224-232.
[13] 王丹.HIV 感染期间持续性免疫激活与肠道微生物易位关系的研究[J].肠外与肠内营养杂志,2015,22(1):57-60,62.
[14] Cotter EJ, Malizia AP, Chew N, et al. HIV proteins regulate bonemarker secretion and transcription factor activity in cultured humanosteoblasts with consequent potential implications for osteoblastfunction and development[J]. AIDS Res Hum Retroviruses,2007, 23(12):1521-1530.
[15] Gibellini D, De Crignis E, Ponti C, et al. HIV-1 triggers apoptosisin primary osteoblasts and HoBIT cells through TNFalphaactivation[J]. J Med Virol, 2008, 80(9):1507-1514.
[16] Rifas L, Weitzmann MN. A novel T cell cytokine, secretedosteoclastogenic factor of activated T cells, induces osteoclastformation in a RANKL-independent manner[J]. ArthritisRheum, 2009, 60(11):3324-3335.
[17] Grigsby IF, Pham L, Mansky LM, et al. Tenofovir treatment ofprimary osteoblasts alters gene expression profiles: implications forbone mineral density loss[J]. Biochem Biophys Res Commun,2010, 394(1):48-53.
[18] Grigsby IF, Pham L, Gopalakrishnan R, et al. Downregulationof Gnas, Got2 and Snord32a following tenofovir exposure ofprimary osteoclasts[J]. Biochem Biophys Res Commun, 2010,391(3):1324-1329.
[19] 李航,张福杰,卢洪洲,等. HIV 感染合并慢性肾脏病患者管理专家共识[J]. 中国艾滋病性病,2017,23(6):578-581.

备注/Memo

备注/Memo:
[基金项目] 南宁市重大科技专项(20163013);广西壮族自治区卫生厅自筹经费科研课题(Z2014476)
[通信作者] 梁纲,E-mail: liangg82921@126.com
更新日期/Last Update: 2017-12-20