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目的分析初始抗反转录病毒治疗(ART)时,使用含有奈韦拉平组合的病人药疹的发生率、发生程度及转归情况。方法采用回顾性临床分析方法,对佑安医院门诊2005年1月至2014年7月,开始进行ART时使用含有奈韦拉平组合的188例艾滋病病毒(HIV)感染者/艾滋病(AIDS)病人,进行药疹的发生率、发生时间、发生程度及转归情况分析。结果 188例病人中,男性174例(92.6%),女性14例(7.4%),平均年龄(38.1±16.8)岁(23~72岁);共发生药疹29例(15.4%),发生中位数时间为14天,18例(9.6%)换药。初始CD+4T淋巴细胞(简称CD4细胞)计数>250个/μL开始进行ART的病人共70例,其中14例(20.0%)在治疗后13天(中位时间)出现药疹,11例(15.7%)换药;CD4细胞计数<250个/μL开始治疗的118例,有15例(12.7%)在治疗后18天(中位时间)发生药疹,7例(5.9%)换药。分别进行χ2检验,不同CD4细胞基数病人发生药疹的概率无统计学意义(P<0.05),但发生药疹后换药率有区别。结论奈韦拉平导致的药疹发生率较高,特别是基线CD4细胞计数>250个/μL的病人,重度药疹发生率高,换药率高,应在初始ART中尽量避免应用奈韦拉平。
Objective To analyze the incidence, incidence, and outcome of drug eruptions in patients receiving nevirapine at initial antiretroviral therapy (ART). Methods A retrospective clinical analysis was conducted on 188 patients with HIV / AIDS infected with nevirapine at ART clinic from January 2005 to July 2014 at the start of ART. The incidence, occurrence time, occurrence and outcome of the situation analysis. Results Of the 188 patients, 174 (92.6%) were male and 14 (7.4%) were female, with an average age of 38.1 ± 16.8 years (range, 23-72 years); 29 (15.4%) were drug eruptions, Number of days for 14 days, 18 cases (9.6%) dressing. A total of 70 patients started ART with a count of> 250 cells / μL for initial CD + 4T lymphocytes (CD4 cells), 14 (20.0%) developed drug eruptions at 13 days (median) %) Dressing; 118 patients started treatment with CD4 counts <250 / μL, and drug eruption occurred in 15 (12.7%) at 18 days (median) and 7 (5.9%) dressing changes. Respectively, the χ2 test, different CD4 cell count in patients with drug eruption rash probability was not statistically significant (P <0.05), but after the occurrence of drug eruption rate was different. Conclusion The incidence of drug eruption caused by nevirapine is high. Especially in patients with baseline CD4 cell count> 250 cells / μL, the incidence of severe drug eruption is high and dressing rate is high. Nevirapine should be avoided as much as possible in initial ART.