Autonomic nervous system dysfunction associated with HIV infection in intravenous heroin users
Autonomic nervous system dysfunction associated with HIV infection in intravenous heroin users
复制标题
静脉注射海洛因使用者中与 HIV 感染相关的自主神经系统功能障碍
DOI：
10.1097/00002030-199201000-00011
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发表时间：
1992
期刊：
影响因子：
3.8
通讯作者：
F. Confalonieri
中科院分区：
文献类型：
--
作者：
A. Villa;V. Foresti;F. Confalonieri
目的探讨HIV阳性吸毒者是否存在自主神经系统（ANS）受累。设计我们调查了37名HIV阳性（和18名HIV阴性对照）静脉注射海洛因使用者，他们没有自主神经或周围神经病变的症状和体征。方法对患者进行临床和免疫学评估，并进行5项心血管反射功能测试。结果22例HIV阳性者出现ANS阳性反应，1例HIV阴性者出现ANS阳性反应。HIV阳性受试者心血管反射功能严重改变者的免疫球蛋白（IG）G和C1q免疫复合物水平显著高于正常受试者。在对17名艾滋病毒阳性受试者的随访中，9名受试者在测试中出现反射恶化和IgG免疫复合物水平升高。结论：结果证实，通过使用足够敏感的测试，临床前自主神经病变的迹象，可以经常发现在HIV阳性静脉注射海洛因使用者，如以前观察到的同性恋患者，并建议存在一个HIV相关的自身免疫发病机制。ANS受累的早期诊断可能很重要，因为自主神经功能障碍的存在可能会增加侵入性手术期间心跳呼吸骤停的风险。
ObjectiveTo evaluate the presence of autonomic nervous system (ANS) involvement in HIV-positive drug users. DesignWe investigated 37 HIV-positive (and 18 HIV-negative controls) intravenous heroin users who were without symptoms and signs of autonomic or peripheral neuropathy. MethodsThe patients were clinically and immunologically assessed and subjected to a battery of five cardiovascular reflex function tests. ResultsThe tests revealed ANS involvement in 22 HIV-positive subjects but only in one HIV-negative subject. Immunoglobulin (Ig) G and C1q immune complex levels were significantly higher in HIV-positive subjects with severe cardiovascular reflex function tests alteration compared to those with normal tests. In a follow-up of 17 HIV-positive subjects, nine presented deteriorated reflexes in the tests and higher IgG immune complex levels. ConclusionsThe results confirm that, by using sufficiently sensitive tests, signs of preclinical autonomic neuropathy can frequently be found in HIV-positive intravenous heroin users, as previously observed in homosexual patients, and suggest the existence of an HIV-related autoimmune pathogenesis. Early diagnosis of ANS involvement could be important, since the presence of autonomic dysfunction could increase the risk of cardiorespiratory arrest during invasive procedures.