艾滋病合并马尔尼菲青霉病256例临床研究  

A clinical study on 256 cases of AIDS complicated with penicilliosis marneffei

作　　者：李勇 蒙志好 苏凌松 杨日耀 覃善芳 

机构地区：[1]广西壮族自治区龙潭医院,柳州545005

出　　处：《中国真菌学杂志》2009年第6期347-350,共4页Chinese Journal of Mycology

基　　金：广西卫生厅科研项目(Z2007031)

摘　　要：目的探讨艾滋病合并马尔尼菲青霉病的流行病学、临床特点、早期确诊方法及治疗方案。方法对2007年1月-2008年12月我院收治的256例艾滋病合并马尔尼菲青霉病患者的临床资料进行回顾性分析。结果1 404例艾滋病患者中合并马尔尼菲青霉病者共256例,发生率为18.2%,患者以发热、消瘦、贫血、咳嗽、咳痰、皮疹、淋巴结肿大为主要表现,外周血CD4＋T淋巴细胞平均值为19×10^6/L,患者往往还合并其他多种机会性感染,以口腔念珠菌病、耶氏肺孢子菌肺炎、结核病等多见。两性霉素B治疗组临床疗效优于氟康唑治疗组,伴有皮疹者和无皮疹者病死率差异有统计学意义（P〈0.001）。结论马尔尼菲青霉病是广西艾滋病患者常见的机会性感染之一,主要发生于CD4＋T淋巴细胞〈50×10^6/L的患者。血培养是早期确诊马尔尼菲青霉病的最有效方法,治疗上首选两性霉素B。Objective To explore the epidemiology, clinical characteristics,early diagnosis and therapy of AIDS with penicilliosis marneffei （PSM）. Methods Clinical data of AIDS patients complicated with PSM in our hospital between January. 2007 and December 2008 were analyzed. Results Two hundred and fifty six in 1 404 AIDS patients were found to be complicated with PSM （ 18. 2% ）. Primary clinical presentation included fever, weight loss, anemia, cough, sputum, rash, and lymphadenopathy. Mean CD4 ＋ lymphocyte counts in peripheral blood was 19 × 10^6/L. Most patients showed other opportunistic infections, including oral candidiasis, pneumocystis pneumonia, tuberculosis, et al. The efficacy of amphotericin B was better than that of fluconazole. There was significant difference in fatality rate between patients with and without rash （ P 〈 0.01 ）. Conclusions PSM is one of the common opportunistic infections in AIDS patients in Guangxi province, which mostly occures in patients with CD4^＋ T cells less than 50 × 10^6/ L. Blood culture is most effective for early diagnosis and amphotericin B was recommended for treatment.

关 键 词：艾滋病 马尔尼菲青霉病 感染 

分 类 号：R379.9[医药卫生—病原生物学]