艾滋病毒感染成人的脂质缩的一个客观案例定义:一个病例对照研究
1HIV, Immunology, and Infectious Diseases Clinical Services Unit, St Vincent's Hospital, Sydney, Australia. acarr@stvincents.com.au
Lancet (London, England)
|March 7, 2003
概括
研究人员开发了一种客观的病例定义,用于艾滋病毒相关的脂质营养不良. 这一新定义改善了诊断,流行率评估和对艾滋病毒患者这种常见疾病的风险因素的理解.
科学领域:
- 传染性疾病 传染性疾病
- 内分泌学 在内分泌学.
- 医学诊断 医学诊断 医学诊断
背景情况:
- 艾滋病毒-1感染和抗逆转录病毒疗法与脂质缩有关,这是一个表现为外周脂质缩,中心脂肪积累和脂质缩的变形状.
- 目前缺乏与艾滋病毒相关的脂质疏松症的验证和客观定义,这阻碍了准确的评估和管理.
- 这项研究的目的是建立一个敏感,具体和广泛适用的HIV脂质缩病例定义.
研究的目的:
- 开发一个客观的,验证的HIV相关脂质缩病例定义.
- 为了提高HIV-1感染的成年患者的脂质缩诊断的准确性.
- 促进对艾滋病毒脂质变的流行率,风险因素和病原体的研究.
主要方法:
- 一项涉及1081名来自32个全球地点的艾滋病毒感染成人门诊患者的病例控制研究.
- 患者被分为病例 (n=417) 或对照 (n=371) 基于通过身体检查和问卷确定的主观脂质变性特征.
- 使用临床,代谢和身体成分测量构建了一个后勤回归模型,并对剩余的患者进行了验证.
主要成果:
- 综合性后勤回归模型包括年龄,性别,艾滋病毒持续时间,疾病阶段,腰比,阴离子间隙,高密度胆固醇,干部和外围脂肪比,腿部脂肪百分比和腹内和腹外脂肪比,实现了79%的灵敏度和80%的特异性.
- 仅使用临床或临床和代谢变量模型的诊断准确性较低.
- 由于临床诊断的患者的发病率低 (<10%),不能可靠地确定脂缩,脂肪积累或脂质化的纯表型.
结论:
- 开发的艾滋病毒相关脂质疏松症的客观病例定义为改善诊断准确性提供了经过验证的工具.
- 预计这一定义将有助于对脂质营养不良的患病率,风险因素和病原体的评估.
- 新的病例定义将有助于制定艾滋病毒脂质缩症的预防和治疗策略.
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