艾滋病合并巨细胞病毒血症患者临床特点分析  

Clinical features of patients with acquired immunodeficiency syndrome complicated by cytomegalovirus viremia

作　　者：肖江[1] 韩宁[1] 何宏宇[2] 王凌航[1] 郜桂菊[1] 梁洪远[1] 杨涤[1] 张黎颖[1] 赵红心[1] 毛羽[1] 

机构地区：[1]首都医科大学北京地坛医院感染一科,100085 [2]首都医科大学北京地坛医院眼科,100085

出　　处：《中华传染病杂志》2011年第8期459-462,共4页Chinese Journal of Infectious Diseases

摘　　要：目的了解AIDS合并CMV血症患者的临床特征。方法回顾性分析2008年10月至2009年11月北京地坛医院住院的249例AIDS患者的临床资料，对其中43例确诊为CMV血症患者的临床症状、脑脊液检查结果、气管镜、胃镜和肠镜检查等资料通过Excel软件建立数据库，并利用统计软件SPSS12．0分析细胞免疫功能和CMVDNA水平的相关性。结果在249例AIDS患者中，43例经过CMVpp65抗原和CMVDNA检测确诊为CMV血症；14例患者眼底镜检查提示视网膜渗出或视网膜出血；4例出现眼底视网膜渗出或出血后机化；通过气管镜肺泡灌洗液病理检查发现1例确诊CMV肺炎；低水平CD4^＋T淋巴细胞和CMVDNA阳性具有相关性。结论对CD4^＋T淋巴细胞〈100×10^6／L的AIDS患者应进行CMVDNA或pp65抗原的筛查，并予以全身抗CMV治疗；眼底镜和气管镜肺泡灌洗液病理检杏是确诊CMV视网膜炎和肺炎的有效方法。Objective To understand the clinical features of patients with human immunodeficiency virus （HIV）/acquired immunodeficiency syndrome （AIDS） complicated by cytomegalovirus （CMV） viremia. Methods The clinical data of 249 cases of HIV/AIDS patients hospitalized in Beijing Ditan Hospital from Oct 2008 to Nov 2009 were analyzed retrospectively, in which 43 HIV/AIDS patients were diagnosed with CMV viremia. The symptoms and signs, cerebrospinal fluid （CSF） tests, and pathological detections by bronchoscope, gastroscope and fibercoloscope were collected. The database was set up using Excel software. The association between cellular immunity and CMV DNA level was determined by SPSS12.0 software. Results Forty-three patients （17.3%） were diagnosed with CMV viremia by positive results of CMV pp65 antigen and CMV DNA tests; 14 patients manifested retinal bleeding or infiltration and 4 patients displayed retinal fibrosis; 1 patient was diagnosed with CMV pneumonitis by pathological results of bronchoalveolar lavage fluid. Low level of CD4^＋ T lymphocytes and CMV DNA levels were positively correlated. Conclusions CMV pp65 antigen and CMV DNA should be detected in HIV/AIDS patients with CD4^＋ T lymphocytes less than 100 ×10^6/L and anti CMV treatment should be given according to the results. Ophthalmologic examination and bronchoalveolar lavage fluid pathological detection are effective methods in diagnose of CMV retinitis and pneumonitis.

关 键 词：获得性免疫缺陷综合征 巨细胞病毒感染 视网膜炎 CD4阳性T淋巴细胞 

分 类 号：R51[医药卫生—内科学]