艾滋病患者消化系统表现、上消化道黏膜病变特点及相关因素  

Digestive system manifestations and upper digestive tract mucosal lesions in acquired immune deficiency syndrome patients: Characteristics and related factors

作　　者：赵健雄 刘满清[2] 

机构地区：[1]贵州省贵阳市公共卫生救治中心内科,贵州省贵阳市550004 [2]湖北省武汉市疾病预防控制中心,湖北省武汉市430000

出　　处：《世界华人消化杂志》2016年第9期1423-1427,共5页World Chinese Journal of Digestology

摘　　要：目的:研究艾滋病(acquired immune deficiency syndrome,AIDS)患者消化系统表现、上消化道黏膜病变特点及相关因素.方法:以有消化道症状且经胃镜检查有胃黏膜病变的127例AIDS患者为观察组,另选择同期收治的无消化道症状且经胃镜检查无消化道黏膜病变的120例AIDS患者为对照组.分别予以2组患者电子胃镜检查及幽门螺杆菌(Helicobacter pylori,H.pylori)检测,并取2组患者胃黏膜组织行CD-38及Ki-67免疫组织化学检测.结果:观察组127例AIDS患者消化系统症状由主到次表现为腹胀、腹痛、腹泻等;观察组AIDS患者上消化道黏膜病变特点表现为慢性浅表性胃炎、慢性萎缩性胃炎、念珠菌性食管炎等,且其中慢性浅表性胃炎(40.94%)与慢性萎缩性胃炎(20.47%)的比例显著高于其他黏膜病变(P<0.05).对照组患者H.pylori感染率为10.83%,观察组为12.60%,2组比较,差异无统计学意义(P>0.05).观察组患者胃黏膜组织CD-38阳性表达高于对照组(P<0.05),Ki-67阳性表达低于对照组(P<0.05).结论:AIDS患者消化系统表现以腹胀、腹痛、腹泻为主,上消化道黏膜病变以慢性浅表性胃炎、慢性萎缩性胃炎为主,胃黏膜组织CD-38高表达及Ki-67低表达可能是诱发AIDS患者出现消化系统症状的重要因素.AIM： To summarize the characteristics and related factors of gastrointestinal mucosal lesions in the digestive system of acquired immune deficiency syndrome（AIDS） patients. METHODS： One hundred and twenty-seven AIDS patients with gastrointestinal symptoms and gastroscopically proven gastric mucous l e s i o n s w e r e i n c l u d e d i n a n o b s e r v a t i o n group. Another 120 AIDS patients without gastrointestinal symptoms and gastroscopically proven gastric mucous lesions were included in a control group. Helicobacter pylori（H. pylori） infection status and CD-38 and Ki-67 expression in gastric tissue were evaluated and compared between the two groups. RESULTS： In the observation group, main digestive system symptoms were abdominal distension, abdominal pain, and diarrhea, and the digestive tract mucous lesions were characterized by chronic superficial gastritis, chronic atrophy gastritis, and candida esophagus, with chronic superficial gastritis（40.94%） and chronic atrophy gastritis（20.47%） being more common than other lesions（P 0.05）. The rate of H. pylori infection did not differ significantly between the control group and observationgroup（10.83% vs 12.60%, P 0.05）. The positive rate of CD-38 was significantly higher but the positive rate of Ki-67 was significantly lower in the observation group than in the control group（P 0.05）.CONCLUSION： Main digestive system symptoms in AIDS patients are abdominal distension, abdominal pain, and diarrhea, and main gastrointestinal mucosal lesions are chronic superficial gastritis and chronic atrophy gastritis. High expression of CD-38 and low expression of Ki-67 may be an important factor causing digestive system symptoms in AIDS patients.

关 键 词：艾滋病 消化系统 黏膜病变 幽门螺杆菌 CD-38 KI-67 

分 类 号：R512.91[医药卫生—内科学] R57[医药卫生—临床医学]