HIV/AIDS患者口腔病损的临床特点分析  

Clinical characteristics of oral lesions in HIV/AIDS patients

作　　者：付茜[1] 肖江[2] 林端娴[1] 梁宏远[2] 赵红心[2] 

机构地区：[1]首都医科大学附属北京地坛医院口腔科,北京100015 [2]首都医科大学附属北京地坛医院感染一科,北京100015

出　　处：《北京口腔医学》2014年第5期276-280,共5页Beijing Journal of Stomatology

摘　　要：目的了解艾滋病相关口腔病损的临床特点及其与CD4计数和高效抗逆转病毒治疗（highly active antiretroviral therapy,HAART）之间的关系。方法回顾性研究2012~2013年在我院收治的109例HIV/AIDS患者的临床资料,包括流行病史、艾滋病临床阶段、口腔表现、全身症状、CD4计数、治疗及预后等,通过Excel建立数据库,进行统计学分析。结果 109例HIV/AIDS患者中48例出现艾滋病相关口腔病损,其中口腔念珠菌感染48例（44.03%）,以假膜型为主,口腔深大溃疡5例（4.59%）,卡波西肉瘤和淋巴瘤各2例（1.83%）,牙龈线型红斑、口腔单纯疱疹和口腔疣各1例（0.92%）。CD4〈200个/ul组口腔病损的发生率高于CD4≧200个/ul（P〈0.01）,HAART治疗组口腔病损的发生率低于未治疗组（P〈0.01）,差异有显著性。结论口腔是HIV/AIDS患者最常见的机会性感染部位。口腔病损中以假膜型口腔念珠菌病最常见,其次是口腔深大溃疡、口腔恶性肿瘤。卡波西肉瘤和淋巴瘤死亡率高,早期口腔表现易与淋巴结炎、牙龈炎混淆,应尽早进行病理检查,早期诊断。HIV/AIDS患者口腔病损的发生与CD4计数减少有关,HAART治疗能显著降低口腔病损的发生。Objective To evaluate the clinical characteristics of oral lesions in HIV/AIDS patients and its relationship with CD4 and highly active antiretroviral therapy（ HAART）. Methods The clinical data of 109 HIV /AIDS in-patients in Ditan Hospital were reviewed,including epidemic data,clinical stages of HIV infection,oral manifestations,CD4 cell counts and prognosis. Results A total of 48 cases（ 44. 04%） of AIDS-associated oral lesions were found in 109 HIV /AIDS patients,in which oral candidiasis（ 43 cases,39. 45%）,especially pseudomembranous one,was the most common oral lesion,followed by severe oral ulcer（ 5 cases,4. 59%）,Kaposi＇s sarcoma and lymphoma（ 2 cases,1. 83%,respectively）,the gum line erythema,oral simplex herpes and oral warts（ 1 case,respectively）. The prevalence of oral lesions in CD4 200 cells /ul group was higher than that in CD4 ≧ 200 cells /ul group（ P〈0. 01）,and the incidence of oral lesions in HAART group was lower than that in untreated group（ P〈0. 01）. Conclusion Oral cavity was the most common site for most opportunistic infection. Pseudomembranous oral Candidiasis was the most common oral lesion,followed by severe oral ulcer and oral malignant neoplasm. Oral lesions in HIV /AIDS patients were associated with lower CD4 cells counts,and HAART medications can significantly reduce prevalence of AIDS-associated oral lesions.

关 键 词：艾滋病 人获得性免疫缺陷病毒 高效抗逆转病毒治疗 口腔病损 CD4计数 

分 类 号：R512.91[医药卫生—内科学] R781[医药卫生—临床医学]