|本期目录/Table of Contents|

[1]张志宏,王金泉.86例HIV感染患者的肾功能状态与危险因素分析[J].医学研究与战创伤救治(原医学研究生学报),2016,18(06):581-584,590.[doi:10.3969/j.issn.1672-271X.2016.06.007]
　ZHANG Zhi-hong,WANG Jin-quan..Risk factors for abnormal renal function in HIV-positive individuals[J].JOURNAL OF MEDICALRESEARCH —COMBAT TRAUMA CARE,2016,18(06):581-584,590.[doi:10.3969/j.issn.1672-271X.2016.06.007]
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86例HIV感染患者的肾功能状态与危险因素分析()
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《医学研究与战创伤救治》（原医学研究生学报）[ISSN:1672-271X/CN:32-1713/R]

卷:
第18卷
期数:
2016年06期
页码:
581-584,590
栏目:
出版日期:
2016-11-20

文章信息/Info

Title:
Risk factors for abnormal renal function in HIV-positive individuals
作者:
张志宏; 王金泉
210002江苏南京，南京大学医学院附属金陵医院（南京军区南京总医院）国家肾脏疾病临床医学研究中心 全军肾脏病研究所[张志宏（中国第19批援赞比亚军医组成员）]
Author(s):
ZHANG Zhi-hong;  WANG Jin-quan.
National Clinical Research Center of Kidney Diseases,Jinling Hospital, Nanjing University School of Medicine, Nanjing, Jiangsu 210002, China
关键词:
人类免疫缺陷病毒; 慢性肾脏病; 危险因素
Keywords:
human immunodeficiency virus;  chronic kidney disease;  risk factors
分类号:
R512.91
DOI:
10.3969/j.issn.1672-271X.2016.06.007
文献标志码:
A
摘要:
目的 分析HIV患者肾功能状态与危险因素，深化对该人群肾损害风险的认识。方法 收集HIV患者临床资料，包含年龄、性别、高血压和糖尿病病史、感染途径、抗逆转录病毒治疗(ART)等，检 测血常规，完善外周血CD4淋巴细胞计数、乙肝表面抗原定性、抗丙型肝炎病毒抗体定性和HIV-RNA定量分析，运用血肌酐值估算肾小球滤过率(eGFR)，Logistic回归分析各因素与肾功能状态的相关关系 。结果 86例黑人HIV患者，女性20例（23.3%），年龄（45.3±10.7）岁，eGFR水平（74.9±23.4）mL/(min·1.73m2)。肾功能损害25例，肾功能正常61例。肾功能损害组患者年龄、高血压与糖尿病比 例、WHO临床分期和基线HIV-RNA定量均显著高于肾功能正常组患者，而Hb、入院CD4淋巴细胞计数和eGFR水平均显著低于肾功能正常组患者（P均＜0.05）。肾功能正常组含替诺福韦（TDF）方案的患者 eGFR水平显著低于未含TDF方案的患者（P＜0.05）。多因素Logistic回归分析显示HIV患者肾功能损害的独立相关因素为年龄≥50岁、合并糖尿病和WHO临床分期。结论 除传统危险因素外，HIV感染及某 些ART药物均可能与HIV患者肾功能损害有关。
Abstract:
Objective To evaluate the prevalence and risk factors for impaired renal function in HIV-positive population. Methods A cross-sectional study of HIV-positive patients was conducted. Baseline clinical characteristics such as gender, age, diabetes, blood pressure, route of transmission, antiretroviral therapy(ART) regimens were obtained. Serum creatinine, hemoglobin(Hb), CD4 lymphocytes(CD4 cell) counts, HBV antigen, HCV antibody, and viral load were measured by standard laboratory techniques. Estimated glomerular filtration rate (eGFR) was calculated using the Modification of Diet and in Renal Disease (MDRD) equation. Risk factors for abnormal renal function, as defined by eGFR<60 mL/ (min·1.73m2) were assessed by Logistic regression model. Results A total of 86 patients were recruited, among them 25 patients with impaired renal function and 61 patients with normal renal function. There were 20(23.3%) female patients. The mean age was (45.3±10.7) years. The mean eGFR was (74.9±23.4) mL/(min·1.73m2). Age, prevalence of hypertension and diabetes, WHO clinical stage and baseline HIV-RNA load were significantly higher in the patients with abnormal renal function, while Hb levels, admission CD4 cell counts and eGFR levels were lower in the patients with abnormal renal function(all P<0.05). eGFR levels in individuals with normal renal function and exposure to tenofovir were significant lower than those without exposure (P<0.05). Multivariate logistic regression revealed older age, diabetes mellitus and WHO clinical stage were associated with impaired renal function. Conclusion Both traditional and HIV-related risk factors(HIV infection, ART regimens that included tenofovir) were associated with impaired renal function in HIV-positive patients.

参考文献/References:

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备注/Memo

备注/Memo:
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更新日期/Last Update: 2016-11-20