人类免疫缺陷病毒感染者胃镜特点分析  

Gastroscopic characteristics of HIV infected patients

作　　者：张月宁[1] 赵媛[1] 李鹏[1] 张世斌[1] 李磊[1] 王贞彪[1] 金瑞[1] 王欣欣[2] 岳竹君[2] 丁惠国[1] 

机构地区：[1]首都医科大学附属北京佑安医院肝病消化中心,北京100069 [2]首都医科大学附属北京佑安医院病理中心,北京100069

出　　处：《中国现代医学杂志》2016年第19期94-99,共6页China Journal of Modern Medicine

摘　　要：目的了解人类免疫缺陷病毒(HIV)感染者胃镜特点。方法选取2010年12月-2015年11月于北京佑安医院确诊HIV感染者胃镜结果及临床、病理资料,进行统计分析。结果 5年共行HIV感染者胃镜检查283例次,门诊124例(43.8%),住院159例(56.2%);男∶女约为7∶1;年龄(39.3±12.4)岁。CD4+T淋巴细胞计数(229.0±21.4)个/μl,<200个/μl有73例,接受高效抗反转录病毒治疗(HAART)221例(92.5%),幽门螺旋杆菌阳性率为26.8%。主诉症状中腹胀和上腹痛最常见,分别为32.2%(79/245)和22.9%(56/245),其次为胸痛、消化道出血、反酸或烧心、恶心或呕吐、吞咽困难等。胃镜主要表现为慢性非萎缩性胃炎30.2%(74/245)、反流性食管炎16.7%(41/245),其次为胆汁反流性胃炎、慢性萎缩性胃炎、胃溃疡、食管溃疡等。结合临床与病理明确诊断恶性肿瘤16例(6.5%),其中胃癌7例,卡波西肉瘤5例,非霍奇金淋巴瘤4例。机会性感染均发生在食管,真菌感染6例(2.4%),结核感染12例(4.9%),巨细胞病毒感染4例(1.6%)。结论 HIV感染者消化道症状并无特异性,但胃镜下异常病变(包括各种机会感染、恶性肿瘤等)检出率高,且症状与疾病严重程度并不一致,故对有症状者仍应尽可能行胃镜检查。Objective To know about the gastroscopic characteristics of HIV infected patients. Methods Gastroscopic results and clinical and pathological data from HIV patients in Beijin You＇an Hospital between Dec. 2010 and Nov. 2015 were collected and analyzed. Results There were 283 HIV cases undergoing gastroscopy in our hospital in the 5 years, including 124 outpatients（43.8%） and 159 inpatients（56.2%）. The ratio of male to female patients was 7 ： 1 and the mean age was（39.3 ± 12.4） years. The mean CD4＋T cell count was（229.0 ± 21.4） / μl. Among the patients, 221（92.5%） patients received highly active antiretroviral therapy（HAART）, 26.8% of the patients were Hp positive. The main complaints were ventosity（79/245,32.2%） and epigastric pain（56/245, 22.9%）. The most common findings from gastroscopy were chronic nonatrophic gastritis（74/245, 30.2%） and reflux esophagitis（41/245, 16.7%）. Malignant tumors were confirmed in16 patients（6.5%）, including 7 cases of gastric cancer, 5 cases of Kaposi＇s sarcoma and 4 cases of non-Hodgkin lymphoma. Opportunistic infections exclusively occurred in esophagus, including 6 cases of fungus infection, 12 cases of TB and 4 cases of CMV infection. Conclusions The findings from gastroscopy of HIV patients are usually clinically meaningful while the gastrointestinal symptoms are not disease defining or paralleled with the severity, suggesting that gastroscopy is necessary for these patients.

关 键 词：艾滋病 人类免疫缺陷病毒 获得性免疫缺陷综合征 胃镜 

分 类 号：R512.91[医药卫生—内科学]