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目的:调查通过献血途径感染人类免疫缺陷病毒(Human immunodeficiency virus,HIV)的203例患者的神经认知状况和社会生活功能。方法:横断面研究,采用神经心理成套测验和日常生活能力量表对安徽阜阳203例通过献血途径感染HIV的患者进行调查,选取198例年龄、性别和受教育年限相匹配的HIV阴性献血者为对照。神经心理成套测验包括执行功能、词语流畅、学习、记忆、精细运动、信息处理速度和工作记忆7个认知领域。以总体缺陷分≥0.5分作为认知损害的划界分。结果:HIV阳性受试总体认知功能[(45.7±5.9)vs.(49.4±6.0),P<0.01]和7个认知领域都较HIV阴性受试差。在精细运动功能方面HIV与丙型肝炎病毒(Heptitis Cvirus,HCV)感染存在交互作用(F=5.28,P<0.05)。临床无症状期的HIV感染者和获得性免疫缺陷综合征(AcquiredImmune Deficiency Syndrome,AIDS)患者认知损害率分别为29.2%和43.0%。HIV阳性受试的日常生活能力下降得分高于HIV阴性受试[(0.49±1.32vs.(0.14±0.75),P<0.01],工作月数、个人和家庭月收入少于HIV阴性受试(P<0.01)。认知损害组患者最低CD4细胞计数低于非认知损害组[(214.3±144.0)vs.(274.8±161.1),P=0.010],日常生活能力下降更明显[(0.75±1.58)vs.(0.34±1.13,)P<0.01]。总体认知功能和日常生活能力下降相关(r=-0.22,P<0.01)。结论:HIV感染者7个神经认知领域均有损害,合并丙型肝炎病毒感染可加重精细运动功能损害,随着疾病进展认知损害率提高;HIV感染者日常生活能力下降、职业功能和经济收入更差。最低CD4细胞计数对神经认知功能受损有一定预测作用;神经认知功能对日常生活能力下降造成一定影响,进而影响个人和家庭的经济收入。
Objective: To investigate the neurocognitive status and social life functions of 203 patients infected with human immunodeficiency virus (HIV) through blood donation. Methods: A cross-sectional study was conducted to investigate the prevalence of HIV infection among 203 HIV-infected donors in Fuyang, Anhui using the Neuropsychological Completeness Test and Daily Life Ability Scale. A total of 198 HIV-negative donors with matched age, sex and education duration were selected as Control. The neuropsychological test consists of seven cognitive domains: executive function, fluent words, learning, memory, fine motor, information processing speed and working memory. The overall defect score ≥ 0.5 points as a marker of cognitive impairment. RESULTS: The overall cognitive function of HIV-positive subjects was (45.7 ± 5.9) vs. (49.4 ± 6.0), P <0.01 and worse than in HIV-negative subjects in all 7 cognitive domains. There was interaction between HIV and Heptitis C virus (HCV) infection in fine motor function (F = 5.28, P <0.05). The prevalence of cognitive impairment in clinically asymptomatic HIV-infected and Acquired Immunocompromised Syndromes (AIDS) patients was 29.2% and 43.0%, respectively. HIV-positive subjects had a greater decline in their daily living capacity than HIV-negative subjects (0.49 ± 1.32 vs. 0.14 ± 0.75, P <0.01), monthly work-months, and less personal and family monthly income than HIV- P <0.01) .The lowest CD4 cell count in cognitive impairment group was lower than that in non-cognitive impairment group (214.3 ± 144.0 vs. 274.8 ± 161.1, P = 0.010) 1.58) vs. (0.34 ± 1.13, P <0.01) .Conclusion: The overall cognitive function is associated with decreased daily living ability (r = -0.22, P <0.01) , Combined with hepatitis C virus infection can aggravate fine motor function impairment, with the progress of the disease cognitive impairment rate increased; HIV-infected people’s ability to daily life decline, occupational function and economic income even worse.The minimum CD4 cell count on cognitive function of the nerve Loss has a certain predictive effect; cognitive function of the nerves decline in daily life caused some impact, thereby affecting the personal and family economic income.