基于真实世界数据的不同用药方案对艾滋病患者血脂水平的影响分析-东南大学学报医学版

基于真实世界数据的不同用药方案对艾滋病患者血脂水平的影响分析

单位：江苏省南通市第三人民医院药剂科, 江苏南通 226006

分类号：R512.91

出版年·卷·期（页码）：2024·43·第四期（580-585）

摘要：

目的: 基于真实世界数据分析不同用药方案对艾滋病患者血脂的影响。方法: 基于医院信息系统(HIS)中真实世界数据,采用分层随机抽样法选取本省16家三级甲等医院,收集2022年1月至7月在上述医院中采用不同用药方案的702例艾滋病患者的病历资料,根据其采用的用药方案分为方案1组[拉米夫定(3TC)+齐多夫定(AZT)+依非韦伦(EFV)]、方案2组[3TC+AZT+奈拉伟平(NVP)]、方案3组[3TC+富马酸替诺福韦酯(TDF)＋EFV]和方案4组(3TC＋TDF＋NVP)。比较各组患者治疗前、治疗6个月后的空腹血脂[总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)和高密度脂蛋白胆固醇(HDL-C)]水平和血脂异常率;比较各组患者用药期间血脂变化导致不良事件的发生情况。结果: 治疗后,各组患者TC、TG、LDL-C水平及血脂异常率高于治疗前,HDL-C水平低于治疗前,且方案3组、方案4组患者TC、TG、LDL-C水平及血脂异常率分别低于方案1组、方案2组,HDL-C水平分别高于方案1组、方案2组(均P<0.05);方案3组、方案4组患者用药期间血脂变化导致不良事件的发生率分别低于方案1组、方案2组(均P<0.05)。结论: 与3TC+AZT+EFV、3TC+AZT+NVP治疗方案相比,3TC+TDF＋EFV、3TC＋TDF＋NVP治疗方案可降低艾滋病患者TC、TG、LDL-C水平,提高HDL-C水平,改善血脂异常,减少血脂异常导致的不良事件。

Objective: To analyze the effect of different drug regimens on blood lipids in AIDS patients based on real world data. Methods: Based on real world data in the Hospital Information System(HIS), 16 Grade Ⅲ and Class A hospitals in the province were selected by stratified random sampling method, and the medical records of 702 AIDS patients using different medication regimentation in the above hospitals were collected from January 2022 to July 2022. According to the medication regimen, they were divided into regimen 1 group [Lamivudine(3TC)+Zidovudine(AZT)+Efavirenz(EFV)], regimen 2 group [3TC+AZT+Nellavepin(NVP)], regimen 3 group [3TC+Tenofovir fumarate(TDF)+EFV] and regimen 4 group(3TC+TDF+NVP). The fasting blood lipid levels [total cholesterol(TC), triglyceride(TG), low density lipoprotein cholesterol(LDL-C) and high density lipoprotein cholesterol(HDL-C)] and dyslipidemia rate in each group of patients were compared before treatment and 6 months after treatment. Adverse events caused by changes in blood lipids were compared between each group of patients during the medication period. Results: After treatment, the levels of TC, TG, LDL-C and dyslipidemia rate in each group of patients were higher than that before treatment, while the level of HDL-C was lower than that before treatment, and the levels of TC, TG, LDL-C and dyslipidemia rate in the in regimen 3 and regimen 4 groups were lower than those in the regimen 1 and regimen 2 groups, respectively, while the level of HDL-C was higher than that in the regimen 1 and regimen 2 groups respectively(all P<0.05). The incidences of adverse events caused by dyslipidemia in regimen 3 group and regimen 4 group were lower than those in regimen 1 group and regimen 2 group, respectively(all P<0.05). Conclusion: Compared with 3TC+AZT+EFV and 3TC+AZT+NVP treatment regimens, the treatment regimens of 3TC+TDF+EFV and 3TC+TDF+NVP can reduce the levels of TC, TG and LDL-C, increase the level of HDL-C, improve dyslipidemia and reduce the incidence of adverse events caused by dyslipidemia in AIDS patients.

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