HIV/AIDS患者皮肤黏膜表现与CD4^+T淋巴细胞计数关系的临床分析  

Relationship of skin and mucosa manifestations with CD4^+T lymphocyte count in HIV / AIDS patients

作　　者：曾林玫 卢祥禅[1] 潘彩芳[1] 梁娟英[1] 伍秋云[1] 

机构地区：[1]南宁市第四人民医院暨广西艾滋病临床治疗中心,南宁市530023

出　　处：《广西医学》2015年第3期313-316,共4页Guangxi Medical Journal

基　　金：国家十二五科技重大专项(2012ZX10001-003)

摘　　要：目的通过分析HIV/AIDS患者皮肤黏膜表现的种类、严重程度及其与CD4+T淋巴细胞计数的关系,评估皮肤黏膜病变预测、评价患者免疫状态的可行性。方法对345例首诊确诊HIV/AIDS患者的临床资料进行回顾性研究,其中192例患者出现皮肤黏膜表现,153例无皮肤黏膜表现。记录患者的CD4+T淋巴细胞计数,观察HIV感染人群中各种皮肤病的发生率并分析皮肤病的种类、严重程度与患者免疫功能的相关性。结果 HIV阳性患者的皮肤病发生率为55.65%(192/345),皮肤黏膜损害的原因复杂,以真菌、病毒感染为主,分别为43.77%(151/345)、11.59%(40/345),其中以口腔念珠菌病发生率最高,达36.23%(125/345),其他包括马尔尼菲霉病、梅毒、单纯疱疹、颈部淋巴结核等都有较高的发生率。无皮肤黏膜表现、出现1种和2种以上皮肤黏膜改变的CD4+T淋巴细胞计数分别为(247±119)个/μl、(84±59)个/μl、(36±23)个/μl,差异均有统计学意义(P<0.05)。结论 HIV/AIDS患者皮肤黏膜表现多样,感染者免疫功能越差,越易并发皮肤黏膜疾病,某些皮肤黏膜表现可作为预测和评估HIV感染者免疫状态的临床指标。Objective To evaluate the feasibility of skin and mucous lesions applied to the prediction and assessment of the immune status of HIV/AIDS patients by investigating the type and severity of skin and mucosa manifestations of HIV/AIDS patients and their relationship with CD4^＋T lymphocyte count. Methods The clinical data of 345 HIV/AIDS patients confirmed in the first visit in the hospital were retrospectively analyzed. There were 192 patients with skin and mucosa manifestations and 153 patients without skin and mucosa manifestations. The CD4^＋ T lymphocyte count was recorded, and the incidences of skin diseases in HIV infection population were observed. The correlation of the type and severity of skin diseases with the patients＇ immune function was analyzed. Results The incidence of skin diseases in HIV-positive patients was 55.65% （ 192/345 ）. The most of skin and mucosa injuries were infected with fungi and viruses ,up to 43.77% （151/345） and 11.59% （40/345） ,respectively. The incidence of oral candidiasis was the highest up to 36.23% （125/345） ,while penicilliosis marneffe,syphilis, simple herpes and tuberculosis of cervical lymph node showed a higher incidence. Significant difference was observed in the CD4^＋ T lymphocyte count among the patients without skin and mucosa manifestations, the patients with one kind of skin and mucosa changes,and the patients with two kinds of skin and mucosa changes or more（ （247 ± 119）/μl, （84 ± 59）/μl, （36 ± 23）/μl, P 〈0.05）. Conclusion HIV/AIDS patients present various skin and mucosa manifestations. Poorer immune function the HIV infectors own, higher incidences of skin and mucosa diseases occur. Some skin and mucosa manifestations can be considered as clinical markers for the prediction and assessment of the immune status of HIV infectors.

关 键 词：人类免疫缺陷病毒 获得性免疫缺陷综合征 皮肤黏膜表现 CD4+T淋巴细胞 

分 类 号：R512.91[医药卫生—内科学]