87例CD4^+T淋巴细胞低水平AIDS患者机会性感染临床分析  

Opportunistic infections in 87 AIDS patients with low CD4^+ T lymphocyte count

作　　者：康文臻[1] 李媛[1] 庄严[1] 黄德东[1] 翟嵩[2] 赵柯[1] 孙永涛[1] 

机构地区：[1]第四军医大学唐都医院传染科,西安710038 [2]西安交通大学第二附属医院传染科,710004

出　　处：《传染病信息》2010年第6期347-349,384,共4页Infectious Disease Information

基　　金：陕西省科学技术研究发展计划项目(2009K18-01)

摘　　要：目的分析CD4+T淋巴细胞低水平AIDS患者机会性感染的临床特点及治疗效果,以提高临床诊疗水平。方法收集我院感染科就诊的87例CD4+T淋巴细胞低于100/μl的AIDS患者的临床资料,回顾性分析其机会性感染谱及预后情况。结果 87例中67例发生机会性感染,主要临床表现为:发热、咳嗽、消瘦、乏力、口腔白斑、头晕、呕吐、气短、腹泻、皮疹、淋巴结肿大等;主要机会性感染依次为:细菌性肺炎、口腔念珠菌感染、肺结核、带状疱疹、肺孢子菌肺炎等。总共发生107例次机会性感染,在接受对症治疗的70例次中,治愈或好转59例次,治疗无效8例次;3例因机会性感染死亡。发生过多种机会性感染的患者与未发生机会性感染患者相比,有较低的CD4+T淋巴细胞水平及较高的病毒载量,但并未显示出统计学差异。结论 CD4+T淋巴细胞低水平的AIDS患者易发各种机会性感染,发生率为77.01%,临床症状复杂多样。早期发现、早期诊断、早期治疗机会性感染对降低AIDS患者的病死率,提高其生活质量尤为重要。Objective To investigate the clinical features and therapeutic effect in opportunistic infections in AIDS patients with low CD4^＋ T lymphocyte count so as to improve clinical diagnosis and treatment. Methods Clinical data of 87 AIDS patients with CD4^＋ T lymphocyte count below 100 cells/μl, treated in the department of infectious diseases of our hospital, were collected to analyze opportunistic infections and prognosis retrospectively. Results Out of 87 patients, opportunistic infections occurred in 67 with the main clinical manifestations such as fever, cough, loss of weight, asthenia, oral leukoplakia, dizziness, vomiting, short breath, diarrhea, exanthems and lymphadenectasis. The main opportunistic infections were bacterial pneumonia, oral candidiasis, tuberculosis, herpes and Pneumocystis carinii pneumonia. Totally opportunistic infections were found in 107 person-times. Of 70 person- times receiving symptomatic treatment, 59 were cured or improved, 8 were proved ineffective, and 3 patients died. Patients with multiple opportunistic infections had lower CD4^＋ T lymphocyte count and higher viral load than those who had no opportunistic infection, but the difference between them was not statistically significant. Conclusions AIDS patients with low CD4^＋ T lymphocyte count have high risk of opportunistic infections with complicated and diversified clinical manifestations. Therefore, early detection, diagnosis and treatment of opportunistic infections play an important role in reducing mortality and improving life quality in AIDS patients.

关 键 词：获得性免疫缺陷综合征 HIV 机会性致病菌感染 T淋巴细胞 

分 类 号：R512.91[医药卫生—内科学]