目的了解山西省农村地区艾滋病患者接受国家免费抗逆转录病毒治疗(ART)后毒副反应发生情况并分析其影响因素。方法对山西省闻喜县2004年7月1日至2009年12月1日纳入免费ART项目的 205例艾滋病患者进行研究,所有患者定期进行毒副反应临床和实验室评估。采用SPSS11.5软件进行统计分析,率的比较采用χ2检验,P<0.05为差异有统计学意义。结果患者中位治疗时间为47.0个月。在治疗过程中,84.6%的患者出现药物相关毒副反应,常见的短期毒副反应有消化系统症状(52.8%)、贫血(38.5%)、疲倦(30.3%)、皮疹(24.1%)和中枢神经系统症状(16.4%)等;中长期毒副反应有肝毒性(17.4%)、外周神经炎(15.9%)和血清淀粉酶升高(9.2%)等。ddI与消化系统症状,AZT与贫血,d4T、ddI和AZT与外周神经炎,NVP和EFV与皮疹和肝毒性,NVP与中枢神经系统毒性以及d4T与血清淀粉酶升高间有一定的特异关联。针对NVP诱导的肝毒性和AZT诱导的贫血,在更换药物后,患者血液生化指标均恢复正常。结论抗病毒治疗开始后短期与长期内有不同的毒副反应谱,且有一定药物特异性,应保持对患者治疗不同阶段常见药物毒副反应的定期监测,及时采取相应措施。 Objective To understand the incidence of side effects of HIV / AIDS patients receiving ART in rural areas of Shanxi Province and analyze the influencing factors. Methods A total of 205 HIV / AIDS patients were enrolled in the free ART project from July 1, 2004 to December 1, 2009 in Wenxi County, Shanxi Province. All patients underwent clinical and laboratory evaluation of toxic and side effects on a regular basis. SPSS11.5 software was used for statistical analysis, rate comparison using χ2 test, P <0.05 for the difference was statistically significant. Results The median treatment time was 47.0 months. During the course of treatment, 84.6% of the patients had drug-related side effects. Common short-term toxicities were digestive symptoms (52.8%), anemia (38.5%), tiredness (30.3%), rash Neurological symptoms (16.4%), etc .; medium and long-term toxic side effects of liver toxicity (17.4%), peripheral neuritis (15.9%) and serum amylase increased (9.2%) and so on. There is a specific association between ddI and digestive symptoms, AZT and anemia, d4T, ddI and AZT with peripheral neuritis, NVP and EFV with rash and hepatotoxicity, NVP with central nervous system toxicity, and d4T with elevated serum amylase. In response to NVP-induced hepatotoxicity and AZT-induced anemia, blood biochemical parameters returned to normal after drug replacement. Conclusions There are different toxic side effects in the short and long term after the initiation of antiviral therapy, and there is a certain drug specificity. Periodic monitoring of common side effects of drugs in different stages of treatment should be kept and timely measures should be taken.