【作者】 曾雅娟；

【导师】 徐群英；

【作者基本信息】 南昌大学 ， 流行病学与卫生统计学， 2012， 硕士

【摘要】 目的：本研究旨在全面了解南昌市接受抗病毒治疗的艾滋病患者的营养状况，对其提出相应的营养指导建议及调整措施，初步探讨抗病毒治疗对艾滋病患者血液生化指标的影响，为进行营养支持疗法提供有价值的参考。方法：以2009年6月1日至7月1日及2010年12月5日至2011年1月5日江西省南昌市第九医院艾滋病门诊收诊的接受抗病毒治疗2年以上的90名艾滋病患者为调查对象，采用食物频率问卷调查和3天24小时膳食回顾法进行膳食结构有关资料的收集，调查研究对象食物摄入情况；采集研究对象的尿液20ml，试验测定尿液中维生素B1、维生素B2、维生素C和肌酐的含量；采集研究对象的血样，分析免疫学指标、病毒学指标、肝功能性指标及贫血检测指标的变化情况。结果：调查对象总能量摄入不足，总体营养水平低于2002年全国调查平均水平，70%患者体质指数正常，调查对象每标准人日能量摄入量为1870kcal（7824KJ），蛋白质、脂肪、碳水化合物摄入量分别为57.8g、52.4g、300.6g，维生素B1、维生素B2、维生素C含量正常的患者比例分别74.4%、81.1%、72.2%，经过一年的抗病毒治疗后，调查对象CD4+T淋巴细胞有不同程度的升高，病毒载量有不同程度的下降，2010年调查对象肝功能指标结果与2009年结果相比有所降低，差异具有统计学意义（P＜0.05）。2010年调查对象贫血性指标的异常率与2009年异常率差异有统计学意义（P＜0.05）。结论：本次调查中的艾滋病患食物摄入量不足，膳食结构不合理，饮食不规律，抗病毒治疗在有效抑制病毒增长的同时也对患者的肝功能、贫血性指标造成影响，因此医院在进行抗病毒治疗的同时应加强营养宣传教育，做好医患沟通，尽可能根据每位患者的病情和营养状况制定个性化的治疗方案和饮食结构。更多还原

【Abstract】 Objective: This study aims to a comprehensive understanding of the nutritionalstatus of AIDS patients under highly active antiretroviral therapy through the dietarysituation investigation, chemistry detection of urine samples and blood parameters,to get the object of study of dietary structure, the nutritional status of water-solublevitamin and blood test results. Nutritional guidance and adjustment measures will begiven according to the results, and preliminary discuss the influence of highly activeantiretroviral therapy to the blood parameters of AIDS patients, provide a valuablereference for nutrition support therapy.Methods: Respondents are90AIDS under highly active antiretroviral therapymore than2years between June1to July1,2009and December5,2010to January5，2011in Nanchang Ninth Hospital,3-day24-hour dietary recall questionnaire andfood frequency questionnaire were used to investigate the dietary intake andnutritional status;20ml of urine collection of respondents was used to measure thecontent of vitamin B1, vitamin B2, vitamin C and creatinine in the urine; Collectedblood samples of respondents，analyse the changing of immunological parameters,virological indicators, liver function parameters and Anemia indicators.Result: The total energy intake of respondents was insufficient, The overallnutrient level was lower than the average of the2002national survey.70%ofpatients had normal BMI. The man-days per standard energy intake of respondentswas1870kcal (7824KJ), and the intake of protein, fat, carbohydrate was57.8g,52.4g,300.6g, respectively. The rate of vitamin B1, vitamin B2and vitamin Ccontent for the normal patients were74.4%,81.1%,72.2%, respectively. After a yearof antiviral therapy, the CD4+T-lymphocytedifferent of respondents increased, andthe viral load decreased. Compared with2009, The liver function index ofrespondents was lower. The difference had statistically significance (P<0.05). Thedifference of anemia index between2009and2010had statistically significance(P<0.05). Conclusion: AIDS patients in this study were lack of food intake, their dietarystructure was irrational and had irregular diet. Highly active antiretroviral therapyhad effectively inhibited the viral growth, but the patient’s liver function, anemiaindicators were impacted at the same time. As a result, propaganda and education ofnutrition were necessary between the highly active antiretroviral therapy. As far aspossible according to each patient’s condition and nutritional status, developpersonalized treatment options and diet.更多还原