PLOS MED：HIV感染者患慢性肾病的风险评分模型建立

2015-04-03 赵洲译 MedSci原创

HIV感染现在已经成为了一种慢性可控的感染，感染者的预期寿命可以接近普通人。尽管联合抗逆转录病毒治疗已经使结果得到改善，但HIV阳性患者仍遭受着逐渐升高的发病率，其中就包括慢性肾病。据报道，HIV感染者中患有慢性肾病者高达33%。发展和实施慢性肾病风险评分可以使得增加具有潜在肾脏毒性的抗逆转录病毒治疗方案的风险和好处形成对比，并且确定慢性肾病的最大风险。研究人员正是要建立一种简单、经过外部验证的可

HIV感染现在已经成为了一种慢性可控的感染，感染者的预期寿命可以接近普通人。尽管联合抗逆转录病毒治疗已经使结果得到改善，但HIV阳性患者仍遭受着逐渐升高的发病率，其中就包括慢性肾病。据报道，HIV感染者中患有慢性肾病者高达33%。发展和实施慢性肾病风险评分可以使得增加具有潜在肾脏毒性的抗逆转录病毒治疗方案的风险和好处形成对比，并且确定慢性肾病的最大风险。研究人员正是要建立一种简单、经过外部验证的可以广泛应用于HIV阳性患者肾脏疾病长期风险评分模型。这将对临床治疗具有指导性的意义。

研究人员从抗HIV药物不良反应数据库（D:A:D）搜集了17954例HIV阳性患者的数据，评估了三次及以上的推估肾小球滤过率。使用tenofovir、atazanavir、atazanavir/ritomavir以及其他升高蛋白酶抑制剂的患者被排除在外。在此次D:A:D研究中，641人出现了慢性肾病。更大的年龄、静脉注射给药、丙肝共感染、女性、高血压、糖尿病和心血管疾病等因素预测慢性肾病。这些因素的校正发病率被用来创建风险评分。基线处的平均风险评分为-2。在低风险组（评分<0）中，五年内慢性肾病患病几率为1：393。评分>5的高风险组和评分0-4之间的中等风险组几率分别为1：47和1：6。

传统的和HIV相关的风险因素都可以用于预测慢性肾病。这些因素可以用来建立风险评分，从而预测HIV感染者患慢性肾病的几率。这可以用来衡量抗逆转录病毒治疗的利弊。无论对于医生还是病患，都将有很长远的意义。

原始出处：

Mocroft A, Lundgren JD, Ross M, Law M, Reiss P, Kirk O, et al. (2015) Development and Validation of a Risk Score for Chronic Kidney Disease in HIV Infection Using Prospective Cohort Data from the D:A:D Study. PLoS Med 12(3): e1001809. doi:10.1371/journal.pmed.1001809

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2015-07-29 sundong

我一直不理解这些评分怎么弄

130 0
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2015-04-11 x35042875

轻度肾脏疾病对母亲和婴儿可能会增加孕期风险

25 0
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2015-04-05 circumcision

#HIV感染者#

80 0
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2015-04-05 ms3994565386320060

#Med#

66 0
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2015-04-05 清氺訫

资料不错

144 0
[GetPortalCommentsPageByObjectIdResponse(id=33735, encodeId=b96b33e3542, content=我一直不理解这些评分怎么弄, beContent=null, objectType=article, channel=null, level=null, likeNumber=130, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3ykRSkuxjt93yc9tvDWfIQItrwiaKSCps5kyrTyDlwic2FgoCWe88wR3ZiaggKYGueDIp26zVgnbzriaQ/0, createdBy=89d71602869, createdName=sundong, createdTime=Wed Jul 29 10:48:00 CST 2015, time=2015-07-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=20229, encodeId=53202022903, content=轻度肾脏疾病对母亲和婴儿可能会增加孕期风险, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20150920/IMG55FDE671A89482379.jpg, createdBy=cef3108336, createdName=x35042875, createdTime=Sat Apr 11 22:19:00 CST 2015, time=2015-04-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1290209, encodeId=fea3129020956, content=<a href='/topic/show?id=f774890827' target=_blank style='color:#2F92EE;'>#HIV感染者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=80, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=8908, encryptionId=f774890827, topicName=HIV感染者)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=f65b226, createdName=circumcision, createdTime=Sun Apr 05 00:23:00 CST 2015, time=2015-04-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1606459, encodeId=7fbc16064599d, content=<a href='/topic/show?id=eb6b1145939' target=_blank style='color:#2F92EE;'>#Med#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=66, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=11459, encryptionId=eb6b1145939, topicName=Med)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=552a19396740, createdName=ms3994565386320060, createdTime=Sun Apr 05 00:23:00 CST 2015, time=2015-04-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=19463, encodeId=94e819463d3, content=资料不错, beContent=null, objectType=article, channel=null, level=null, likeNumber=144, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2018/03/28/a28e8ea268716dfc601012321847bccf.jpg, createdBy=e21a1620364, createdName=清氺訫, createdTime=Sun Apr 05 00:15:00 CST 2015, time=2015-04-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=19462, encodeId=72e419462eb, content=好，很好啊, beContent=null, objectType=article, channel=null, level=null, likeNumber=191, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2018/03/28/a28e8ea268716dfc601012321847bccf.jpg, createdBy=e21a1620364, createdName=清氺訫, createdTime=Sun Apr 05 00:14:00 CST 2015, time=2015-04-05, status=1, ipAttribution=)]
2015-04-05 清氺訫

好，很好啊

191 0

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