HIV感染者结肠镜特点分析  

The colonoscopic characteristics of HIV infected patients

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

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：《胃肠病学和肝病学杂志》2018年第1期62-65,共4页Chinese Journal of Gastroenterology and Hepatology

基　　金：佑安肝病艾滋病基金(YNKT20160027)

摘　　要：目的了解HIV感染者结肠镜特点。方法采集北京佑安医院2010年12月至2015年11月确诊HIV感染者结肠镜结果及临床、病理资料。结果 5年间共行HIV感染者结肠镜检查207例次,门诊110例次(53.1%),住院97例次(46.9%);结肠镜检查者共190例,男182(95.8%),女8例(4.2%),年龄(38.9±12.4)岁(20~80岁)。粪便病原学检测阳性率6.0%(10/168),显著低于结肠镜病理检测(18.0%,22/122),差异有统计学意义(P<0.05)。主诉症状中腹泻最为常见(51.6%),其次为便血(17.4%)、腹痛(13.7%)。镜下异常表现主要为炎性改变45例(23.7%),其次为息肉、溃疡、隆起性病变等。病理报告非特异性炎最常见(39.3%,48/122);恶性肿瘤11例(9.0%);机会性感染病原体包括CMV 11例、结核5例,真菌及阿米巴各3例。结论结肠镜检查有助于HIV感染者出现消化道症状时肠道病变的诊断及病原学确定,尤其对于症状重的患者更应及早进行结肠镜检查。Objective To investigate the colonoscopic characteristics of HIV infected patients. Methods Data of colonoscopy results from HIV patients in Beijin You＇an Hospital from Dec. 2010 to Nov. 2015 were collected and analyzed according to the clinical and pathological information. Results There were 207 HIV case-times,190 patients（ the male was 182,the female was 8,and the mean age was（ 38. 9 ± 12. 4） years old undergoing colonoscopy,including 110 case-times outpatients（ 53. 1%） and 97 case-times inpatients（ 46. 9%）. The etiology was confirmed through faecal tests in 6. 0%（ 10/168）,significantly lower than that verified by biopsy during colonoscopy（ 18. 0%,22/122）.The main complaints were diarrhea（ 51. 6%）,hematochezia（ 17. 4%） and abdominal pain（ 13. 7%）. The most common findings from colonoscopy were nonspecific inflammatory（ 39. 3%,48/122）. Malignant tumors were found in 11 cases（ 9. 0%）. Pathogenic microorganisms detected through pathological study included 11 CMV,5 mycobacterium tuberculosis,3 fungus and 3 ameba. Conclusion Colonoscopy is helpful in the diagnosis of enteropathy and its etiology in patients with digestive tract disorders,especially for those with severe symptoms.

关 键 词：获得性免疫缺陷综合征 人类免疫缺陷病毒 结肠镜 

分 类 号：R512.91[医药卫生—内科学] R574.62[医药卫生—临床医学]