HIV感染是外周動脈粥樣硬化的獨立危險因素

 
2010年03月02日
 
    據中國醫藥報北京訊北京協和醫院研究發現，艾滋病病毒（HIV）感染者較健康人群更易發生周圍血管動脈粥樣硬化性疾病，但使用特定的雞尾酒療法方案可以改善、預防或延緩周圍血管疾病的發生。這一研究成果發表在2月最新一期的國際著名刊物《艾滋病雜誌》上。
    既往研究已明確HIV感染可顯著增加冠狀動脈疾病的風險，但是否增加周圍血管動脈粥樣硬化尚不明確。為了找到HIV感染與外周動脈粥樣硬化之間的關係，北京協和醫院感染科李太生教授與心內科曾勇等選取41例未經治療的HIV感染者和艾滋病患者、41例接受了雞尾酒治療的HIV感染者和艾滋病患者，以及43位健康對照者為研究對象，進行了經典心血管危險因素、HIV感染指標以及用於診斷外周動脈疾病的脈搏波速度（PWV)及踝臂指數（ABI）等指標的檢測。
    PWV指數是目前較公認的測定動脈彈性功能的方法之一，ABI指數是踝部動脈收縮壓與上臂動脈收縮壓之比，臨床上主要用於診斷下肢外周動脈疾病，與心腦血管疾病事件發生具有良好的相關性。 PWV指數越高，表明血管的彈性越差；ABI指數越低，表明患病風險越大。研究數據表明：未經治療的HIV感染者和艾滋病患者PWV指數顯著高於正常，而ABI指數低於對照組，提示HIV感染可明顯增加動脈粥樣硬化疾病的風險。數據還表明：經過雞尾酒療法治療的HIV感染者和艾滋病患者的PWV指數比未經治療者明顯下降，而ABI指數有所回升，提示特定的雞尾酒療法方案有望改善、預防或延緩外周血管疾病的發生。此外，多因素回歸分析顯示，HIV感染是降低ABI的獨立風險因素，即HIV感染是外周血管動脈粥樣硬化的獨立危險因素。這也就意味著，HIV感染者和艾滋病患者更容易發生如高血壓、腦梗塞或腦出血等嚴重威脅患者存活的血管疾病。
    課題組負責人李太生教授介紹說，“雞尾酒療法的廣泛使用，極大地延長了艾滋病患者的壽命，使我們有機會對長期感染HIV者的繼發疾病展開深入的研究。本研究提示我們，應對HIV感染者和艾滋病患者易發生外周血管動脈粥樣硬化疾病的情況予以關注，並積極採取措施預防和延緩其發生。”
  
 來源：中國醫藥報
 作者：段文利
 責編：江水

HIV infection is peripheral atherosclerosis independent risk factor for

 
March 2, 2010
 
    It is reported that Beijing Chinese Medicine News Beijing Union Medical College Hospital study found that AIDS virus (HIV) infection compared with healthy people more likely to have peripheral vascular atherosclerotic disease, but using a specific cocktail therapy programs could be improved, to prevent or delay peripheral vascular disease, occurred. This research result was published in February the latest issue of the internationally renowned journal "AIDS 杂志" 上.
    Past research has clearly HIV infection can significantly increase the risk of coronary artery disease, but whether the increase in peripheral vascular atherosclerosis is not clear. In order to find HIV infection and peripheral atherosclerosis in the relationship between the Beijing Union Medical College Hospital Department of Infectious Diseases Professor Li Taisheng courage and heart and other internal medicine has selected 41 patients with untreated HIV-infected persons and AIDS patients, 41 patients received the cocktail treatment for HIV infected persons and AIDS patients, as well as 43 healthy controls for the study, carried out the classic cardiovascular risk factors, HIV infection indicators, and used to diagnose peripheral arterial disease, pulse wave velocity (PWV) and ankle-brachial index (ABI) and other indicators of testing.
    PWV index is now more recognized as the determination of arterial elasticity function of one of the methods, ABI is the ankle systolic blood pressure index and arm ratio of systolic blood pressure in clinical practice is mainly used for diagnosis of lower extremity peripheral arterial disease, and cardiovascular and cerebrovascular disease events occur has a good correlation. The higher the PWV index, indicating the flexibility of blood vessels worse; ABI lower index, indicating that the greater risk. The data shows that: without the treatment of HIV-infected persons and AIDS patients PWV index was significantly higher than normal, while the ABI index is lower than the control group, suggesting that HIV infection can be significantly increased atherosclerotic disease risk. The data also show that: After a cocktail therapy for HIV-infected people and AIDS patients untreated PWV index were significantly decreased, while the ABI index rebounded, suggesting that a specific cocktail program is expected to improve, prevent or delay the occurrence of peripheral vascular disease . In addition, multivariate regression analysis showed that, HIV infection is an independent risk factor for lower ABI, that HIV infection is a peripheral vascular atherosclerosis independent risk factor. This means that, HIV infected persons and AIDS patients more vulnerable to problems like hypertension, cerebral infarction or cerebral hemorrhage such as a serious threat to the survival of patients with vascular disease.
    Research Group Leader Professor Li Taisheng, said, "cocktail therapy widely used, greatly extending the life of AIDS patients so that we have the opportunity to long-term infection of those with secondary disease, HIV-depth research. This study indicates that we are to cope with HIV infected persons and AIDS patients prone to peripheral vascular disease, atherosclerosis to be concerned about the situation and to actively take measures to prevent and delay its occurrence. "
  
 Source: China Pharmaceutical News
 Author: DUAN Wen-li
 Zebian: river