艾滋病相关淋巴瘤10例治疗体会  

Treatment of AIDS-Related Lymphoma:A Report of 10 Cases

作　　者：刘保池[1] 王盟[2] 冯艳玲[1] 陈辉[1] 李垒[1] 司炎辉[1] 曹烨[1] 张伟伟[1] 

机构地区：[1]上海市公共卫生临床中心,201508 [2]郑州大学第一附属医院急诊科,在读博士生450000

出　　处：《中华全科医学》2011年第6期841-843,F0003,共4页Chinese Journal of General Practice

基　　金：上海市公共卫生临床中心课题(KSF0222)

摘　　要：目的探讨艾滋病相关淋巴瘤的临床特点与治疗措施。方法对10例HIV感染者合并淋巴瘤（均为男性,年龄25～66岁）术前和术后检测免疫功能,规范手术操作程序,精细操作减少手术损伤,对合并血友病患者术中持续输注Ⅷ因子,常规应用抗生素预防感染,及时处理并发症。给予高效价抗逆转录病毒治疗和CHOP方案全身化疗。结果患者手术前CD4 T淋巴细胞（173.2±108.8）cell/μl,手术后2周复查CD4 T淋巴细胞（169.3±111.6）cell/μl,差异无统计学意义（P〉0.05）。手术均顺利,仅1例伤口感染,无严重手术并发症。3例在术后3～7个月死亡,另7例在治疗和随访中,已随访6～24个月。结论艾滋病相关淋巴瘤患者免疫功能明显低下,CD4 T淋巴细胞明显低于正常人群。但是早期手术切除病灶,合适的抗病毒治疗加全身化疗可能取得较好的疗效。Objective To probe the clinical characteristic and treatment measure of AIDS-related lymphoma.Methods Ten AIDS-related lymphoma patients（male 10,age 25 to 66 years） were enrolled in this study.The immune function of all patients was detected before and after the operation.The standardized surgical procedures,careful surgical process were performed to reduce the operation damage.The continuous infusion of coagulation factors Ⅷ was performed in haemophilia patients during operation.The conventional application of antibiotics to prevent infection and promptly treatment of complications,HAART and CHOP chemotherapy were employed.Results The preoperative CD4 T lymphocyte was（173.2±108.8）cell/μl and postoperative CD4 T lymphocyte was（169.3±111.6）cell/μl（P0.05）.The operations were safety.One incision infected.No severe operative complications.Three cases died within 7 months after the operation;other seven cases still survive with follow up 6-24 months.Conclusion The patients with AIDS-related lymphoma usually have immunological dysfunction.CD4 T lymphocyte is lower than normal.The early operation and thorough resection of lymphoma,suitable treatment with HAART and CHOP chemotherapy may obtain a better effect for AIDS-related lymphoma.

关 键 词：艾滋病 淋巴瘤 手术 化疗 

分 类 号：R512.91[医药卫生—内科学] R733.41[医药卫生—临床医学]