AIDS合并巨细胞病毒性视网膜炎73例临床分析  

Clinical Analysis on 73 AIDS patients with Cytomegalovirus Retinitis

作　　者：卢祥婵[1] 

机构地区：[1]广西南宁市第四人民医院感染科,南宁市530023

出　　处：《广西医学》2012年第1期20-23,共4页Guangxi Medical Journal

基　　金：广西医疗卫生科研课题(Z2010158);广西南宁市科学研究与技术开发计划;创新计划项目(201003047C-2)

摘　　要：目的探讨获得性免疫缺陷综合征(AIDS)合并巨细胞病毒性视网膜炎的临床特点及其与CD4+T细胞计数关系。方法对449例HIV/AIDS病人进行间接检眼镜检查,并对其中合并巨细胞病毒性视网膜炎73例患者的临床表现、眼底改变及CD4+T细胞计数进行分析。结果 449例HIV/AIDS病人中检出巨细胞病毒性视网膜炎73例,检出率为16.26%,其中单眼受累28例,双眼受累45例;有视力改变61例,占83.56%。眼底表现为沿血管分布的黄白色病理改变,伴有片状出血,很少累及玻璃体。449例患者中CD4+T细胞计数≤50个/μl的患者巨细胞病毒性视网膜炎检出率为19.74%(45/228),明显高于CD4+T细胞计数>50个/μl患者的12.67%(28/221)(P<0.05)。结论巨细胞病毒性视网膜炎多发生于AIDS晚期患者,多数患者视力未发生改变时,其眼底早就发生病变,对CD4+T细胞低下而眼部无症状的AIDS患者应常规行眼底镜检查,对于改善巨细胞病毒性视网膜炎的预后有重要意义。Objective To investigate the clinical features of acquired immune deficiency syndrome （AIDS） patients with cytomegalovirus （CMV） retinitis and its relationship with CD4＋ T cell count. Methods We examined the fundus of HIV/AIDS patients by indirect ophthalmoscopy, and analyzed the clinical symptoms and CD4 ＋ T cell count of patients who were diagnosed with CMV retinitis. Results 73 patients were found with CMV retinitis in 449 HIV/AIDS patients ,the rates of which were 16.26% ,included 28 patients with one eye involved and 45 patients with two eyes involved. The vision of 61 patients was changed,the rates of which were 83.56%. The fundus manifestations included yellow-white lesions along vascular distribution and hemorrhage of retina. The vitreum was rarely involved. The incidence of CMVretinitis in patients with CD4＋T cell count below 50 cell/~l was significantly higher than that in the patients with CD4＋ T cell count above 50 cell/μl （P 〈 0. 05 ）. Conclusion CMV retinitis usually occurs in late-stage AIDS patients. Most of HIV/AIDS patients have fundus change without vision change. Routine fundus examination is important to improve the prognosis of CMV retinitis in the patients with low CD4＋T cell count but without ocular symptoms.

关 键 词：获得性免疫缺陷综合征 巨细胞病毒性视网膜炎 间接眼底镜 

分 类 号：R512.91[医药卫生—内科学]