广西地区人类免疫缺陷病毒感染者及获得性免疫缺陷综合征患者口腔病变特点的临床观察  

Clinical features of oral lesions in patients with human immunodeficiency virus infection/ acquired immunodeficiency syndrome in Guangxi autonomous region

作　　者：雍翔智[1] 蒋兰岚 卢祥婵[2] 刘伟[3] 吴念宁[2] 陶人川[1] 

机构地区：[1]广西医科大学附属口腔医院牙周黏膜科, 南宁530021 [2] 南宁市第四人民医院艾滋病科 [3] 广西壮族自治区疾病预防控制中心艾滋病科

出　　处：《中华口腔医学杂志》2014年第8期459-463,共5页Chinese Journal of Stomatology

基　　金：国家自然科学基金（81060085、81260167）

摘　　要：目的 分析人免疫缺陷病毒（human immunodeficiency virus,HIV）感染及获得性免疫缺陷综合征（acquired immune deficiency syndrome,AIDS）患者的常见口腔病损,提高口腔医师对HIV/AIDS早期临床表现的诊断能力.方法 对127例确诊的HIV/AIDS患者进行病史采集及口腔黏膜健康状况检查和分类,同时取患者外周静脉血,采用流式细胞技术检测CD4T淋巴细胞计数.依据美国疾病控制与预防中心颁布的分级标准将患者分为HIV携带组（42例）和AIDS组（85例）,对两组患者口腔表征与系统疾病的关系及口腔表征在两组间的患病率差异采用卡方检验,对口腔表征与CD4T细胞计数的相关性采用Spearman相关分析,以双侧P＜0.05为差异有统计学意义.结果 HIV/AIDS常见的口腔表征中口腔念珠菌病占40.2％ （51/127）,毛状白斑占18.9％（24/127）.口腔表征的出现与系统疾病患病无显著相关性（x2=0.718,P=0.397）,两组患者的口腔表征总体间及口腔念珠菌病患病率间差异均有统计学意义（x2=7.684,P=0.006;x2=14.410,P＜0.001）,两组患者毛状白斑的患病率差异无统计学意义（x2=0.988,P=0.320）.口腔表征及口腔念珠菌病的患病与CD4T细胞计数均呈负相关（r=-0.243,P=0.006;r=-0.265,P=0.003）,毛状白斑的患病与CD4T细胞计数无相关性（r=0.019,P=0.835）.结论 HIV/AIDS患者在系统疾病出现前即可出现明显的口腔表征,并以口腔念珠菌病、毛状白斑最常见;口腔表征的出现与全身系统疾病发病无明显相关关系,但口腔表征可作为观察HIV/AIDS进展的一个重要指标.Objective To investigate the features of oral lesions in patients with human immunodeficiency virus infection/acquired immunodeficiency syndrome（HIV/AIDS）.Methods A total of 127 HIV-seropositive patients were interviewed for health information and examined for their HIV-related oral lesions according to the EC Clearing House Criteria on Oral Problems related to HIV-Infection （1992）.The examinations were conducted by dental specialist and HIV specialist.The CD4 T cell count in peripheral blood of the patients was tested by flow cytometry.The patients were divided into HIV-infected group（42） and AIDS group（85） according to CDC Classification System for HIV-Infected Adults and Adolescents（revised in 1993）.Chi-square test was used to test the relationship between systemic disease and oral lesions,and the difference of the prevalence of oral lesions between the two groups.Results Among the 127 patients,oral candidiasis（51/127）,oral hairy leukoplakia（24/127） were common oral manifestation.There was no relationship between the oral manifestation and systemic disease（P=0.397）.The occurrence of oral lesions and oral candidiasis was significantly different between the two groups（x2=7.684,P=0.006; x2=14.410,P〈0.001）.The CD4 count was related to the prevalence of oral lesions （P==0.006） and oral candidasis （P=0.003）.Conclusions Most oral lesions appeared before the appearance of systemic disease.Oral candidiasis and oral hairy leukoplakia were the most common lesions.Oral lesions had no relationship with systemic disease but could be still an indicator for disease progress.

关 键 词：获得性免疫缺陷综合征 人免疫缺陷病毒 念珠菌病 口腔 白斑 毛状 口腔表征 

分 类 号：R512.91[医药卫生—内科学]