获得性免疫缺陷综合征患者临床及结肠黏膜病变特征的研究  

Study on AIDS clinical and pathological characteristics of colorectal mucosa

作　　者：王贞彪[1] 孙承民[2] 

机构地区：[1]首都医科大学附属北京佑安医院消化科,北京100069 [2]北京地坛医院内窥镜室,北京100015

出　　处：《临床荟萃》2010年第17期1480-1483,共4页Clinical Focus

摘　　要：目的对26例获得性免疫缺陷综合征（AIDS）患者的结肠黏膜病变特征进行临床研究。方法回顾性总结近10年来有结肠镜检查和组织病理学检查的26例AIDS患者的临床资料。结果 26例AIDS患者均有发热和腹泻等症状。其中以发热、咳嗽为首发症状者19例（73.1%）,体温最高达39.5℃。以腹痛、腹泻为首发症状7例（26.9%）,同时伴有不同程度的里急后重、水样或黏液便,大便3~10次/d;26例患者中有20例（76.9%）有程度不等的口腔溃疡、鹅口疮、咽痛、吞咽困难或胸骨后疼痛等症状,大便潜血和脓血便阳性率高,分别达69.2%（18/26）和57.7%（15/26）;结肠镜检查：84.6%（22/26）患者有不同程度病变,其中慢性结肠炎11例,结肠溃疡10例,回盲部恶性淋巴瘤1例;病变部位以直肠及乙状结肠多见,病变波及直肠者,腹泻症状重;组织病理学检查无特异性;病原学检查：16例活检结肠黏膜组织中检出病原体7例（43.8%）。结论发热和腹泻是AIDS的常见症状;AIDS患者结肠病变多见,表现为慢性结肠炎和结肠溃疡,偶见肿瘤;病变波及直肠者,临床症状重;大便潜血阳性或脓血便,多提示肠道有病变。Objective To investigate the clinical features of colonic mucosal lesions from 26 cases of AIDS patients.Methods Retrospective studies were performed in 26 patients who received colonoscopy and histopathological examination in the last 10 years.Results 26 cases of AIDS patients had fever and diarrhea and other symptoms.73.1% of them with fever（T up to 39.5 ℃）,cough as the first symptom,26.9% for abdominal pain,diarrhea as the first symptom,accompanied by varying degrees of tenesmus,watery or mucous stool,76.9% had varying degrees of oral ulcers,thrush,sore throat-difficult swallowing or retrosternal pain and other symptoms.The positive expression rate of stool occult blood and bloody mucopurulent stool were 69.2%（18/26） and 57.7%（15/26） respectively.Colonoscopy showed that 84.6%（22/26） of patients had different degrees of lesion,among which 11 cases were chronic colitis,10 cases were colon ulcer and one case was ileocecal malignant lymphoma.Rectum and sigmoid colon lesions were common in those patients,symptoms of diarrhea were more severe when lesions spread to the rectum.Histopathologic examination was non-specific.Pathogenic check：in 16 cases of AIDS patients,7 samples inspected up out pathogenic organisms（43.8%）.Conclusion Fever and diarrhea are common symptoms of AIDS.Colonic lesions are more common in patients of AIDS,manifested as chronic colitis and colon ulcers,occasionally tumors.Clinical symptoms are more severe when lesions spread to the rectum.Even more,patients with fecal occult blood positive or bloody purulent stool will be more prompted to intestinal lesions.

关 键 词：获得性免疫缺陷综合征 肠黏膜 病理状态 体征和症状 

分 类 号：R512.91[医药卫生—内科学]