AIDS合并巨细胞病毒性视网膜炎79例的诊治  

Diagnosis and treatment of cytomegalovirus retinitis in 79 patients with AIDS

作　　者：朱翠萍[1] ZHU Cuiping(Department of Ophthalmology,Sixth People’s Hospital of Zhengzhou,Zhengzhou 450015,Chin)

机构地区：[1]郑州市第六人民医院(河南省传染病医院)眼科,郑州450015

出　　处：《中国实用眼科杂志》2018年第1期24-27,共4页Chinese Journal of Practical Ophthalmology

摘　　要：目的总结获得性免疫缺陷综合征(AIDS)合并巨细胞病毒视网膜炎(CMVR)的临床特征.方法回顾79例(119只眼)CMVR患者的临床资料,分析其临床特征.结果79例(119只眼)CMVR患者中,男52例,女27例,平均年龄(41.56±13.17)岁.CD4^+T淋巴细胞计数0~144/μl,平均(26.53±28.86)/μl,69例低于50/μ1.CD4^+T淋巴细胞计数在<50/μl、50~100/μl、以及>100/μl三组间的CMVR患病率的两两间差异均有统计学意义(均P<0.05).75例(94.9%)CMVDNA(+).2例(3只眼)以CMVR为首发症状就诊.首诊时63只眼(52.3%)视力低于0.3,其中28只眼(23.5%)视力低于0.05.经抗CMV治疗,46只眼治愈,56只眼好转,治愈加好转率为85.7%(102/119).33只眼早期病变者,治愈后无眼部并发症,视力不变或提高.治疗后仍有27只眼视力低于0.05,盲目率22.7%(27/119).结论CD4^+T淋巴细胞计数≤100/μl是CMVR发生的危险因素,CMVDNA是比较敏感的病原学检测,早期抗CMV治疗对视力预后至关重要.Objective To summarize clinical characteristics in diagnosis and treatment of cytomegalovirus retinitis(CMVR)with acquired immunodeficiency syndrome(AIDS)patients.Methods Review clinical and laboratory data of 79 cases(119 eyes)of CMVR patients,analyze their relations with clinical features.Results Among 79 patients(119 eyes),52 are male and 27 female.Their ages ranged from 8 to 73,averaging at(41.56±13.17).CD4^+T lymphocyte counts ranged from 0 to 144/μll,with 69 cases below 50/μl and averaging at(26.53±28.86)/μl.It is meaningful to compare cases with CD4^+T lymphocyte counts>100/μl,50~100/μl,and<50/μl(P<0.05).Among the cases,75 cases(94.9%)are positive CMVDNA.2 cases(3 eyes)are with eye initial symptoms.Eye-sights of 63 eyes(52.3%)were below 0.3,including 28(23.5%)below 0.05.After anti-CMV treatments,102 eyes were either cured or bettered.There were 27 eyes(27.7%)with sights less than 0.05.Conclusions Poor CD4^+T lymphocyte count as below or equal 100/μl is the main reason of CMVR.And CMVDNA is a sensitive pathogenic detection.Anti-CMV treatments is very important for the treatment and prognosis.

关 键 词：AIDS HIV 巨细胞病毒性视网膜炎 诊断 治疗 

分 类 号：R512.91[医药卫生—内科学] R774.11[医药卫生—临床医学]