人类免疫缺陷病毒阳性患者股骨头缺血性坏死的临床特点浅析

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摘要目的探讨人类免疫缺陷病毒(human immunodeficiency virus，HIV)阳性患者发生股骨头坏死的临床特点，分析其危险因素。方法选取2015年10月至2019年10月我院就诊的81例HIV阳性合并股骨头坏死患者为观察组，选取同时期性别年龄相对应的81例非HIV阳性股骨头坏死患者为对照组，比较两组的临床特点。结果两组在职业、患病部位、国际骨循环研究会(the assciation research circulation osseuse，ARCO)股骨头坏死分期、髋部疼痛视觉模拟评分(visual analogue scale，VAS)、髋关节屈曲度、Harris髋关节功能评分等方面差异无统计学意义(P＞0.05)；两组在高血压、心血管疾病、糖尿病、高脂血症等合并症、血清白蛋白等方面差异无统计学意义(P＞0.05)。观察组患者酒精相关性股骨头坏死的比例(2.50%)明显低于对照组患者(43.21%)，差异有统计学意义(P<0.05)；观察组患者血红蛋白水平和身体质量指数(body mass index，BMI)明显低于对照组，差异有统计学意义(P<0.05)。观察组患者的外周血CD4+T细胞计数普遍偏低，其中CD4+T细胞<200个/μL 32例(39.51%)。结论 HIV阳性患者相比正常人群在股骨头坏死的患病部位和严重程度差异无统计学意义；在HIV阳性患者中，酒精相关性股骨头坏死患者比例明显较对照组低；此类患者外周血CD4+T细胞计数普遍偏低，手术治疗时需要引起一定的重视。

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关键词 ：人类免疫缺陷病毒, 股骨头坏死, 病因

Abstract：Objective To investigate the clinical characteristics and risk factors of femur head necrosis in human immunodeficiency virus(HIV)positive patients.Methods 81 HIV-positive patients with femoral head necrosis admitted to our hospital from October 2015 to October 2019 were selected as the observation group，and 81 non-HIV-positive patients with femoral head necrosis corresponding to gender and age at the same period were selected as the control group.The clinical characteristics of the two groups were compared.Results There was no statistical difference(P＞0.05)between observation group and control group in career，location，ARCO stage，hip pain visual analog scale(visual analogue scale，VAS)score，hip flexion and Harris hip joint function score，no differences were found between the two groups in hypertension，cardiovascular disease，diabetes，hyperlipidemia and other complications，serum albumin were found no statistical difference between the two groups(P＞0.05)，The ratio of alcohol-induced femoral head necrosis in the observation group(2.50%)was significantly lower than that in the control group(43.21%)，and the difference was statistically significant(P<0.05).The hemoglobin level and BMI of the observation group were significantly lower than that in the control group(P<0.05).The count of CD4+T cells in peripheral blood of patients in the observation group was generally low，among which 32 cases(39.51%)had CD4+T cells <200 / μL.Conclusion There is no significant difference in the incidence and severity of non-traumatic femoral head necrosis in HIVpositive patients compared with the normal population.Among HIV-positive patients，the ratio of alcohol-induced non-traumatic femoral head necrosis is significantly lower than that of the control group.CD4+T cell count in peripheral blood of such patients is generally low，so certain attention should be paid during surgical treatment.

Key words： human immunodeficiency virus necrosis of femoral head the cause

通讯作者: 张强

作者简介: 李曙光(1986— )，男，主治医师，首都医科大学附属北京地坛医院骨科，100015。

引用本文:

李曙光，赵汝岗，张耀，王晶晶，赵昌松，张强 *. 人类免疫缺陷病毒阳性患者股骨头缺血性坏死的临床特点浅析[J]. 实用骨科杂志, 2021, 27(6): 497-500.
Li Shuguang，Zhao Rugang，Zhang Yao，et al. Characteristics of Femeral Head Necrosis in Human Immunodeficiency Virus(HIV)-Positive Patients. sygkzz, 2021, 27(6): 497-500.

链接本文:

http://www.sygkzz.com/CN/ 或 http://www.sygkzz.com/CN/Y2021/V27/I6/497

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