与获得性免疫缺陷综合征相关的卡波济肉瘤在眼部的临床表现  

Ocular clinical manifestations of Kaposis sarcoma associated with acquired immunodeficiency syndrome

作　　者：何太雯[1] 卢洪洲[1] 杨娅玲[1] 张仁芳[1] 刘莉[1] 江睿 HE Taiwen;LU Hongzhou;YANG Yaling;ZHANG Renfang;LIU Li;JIANG Rui(Shanghai Public Health Clinical Center,Shanghai 201508,China;Department of Ophthalmology,Eye Ear Nose Throat Hospital of Fudan University,Shanghai 200031,China)

机构地区：[1]上海市公共卫生临床中心眼科,上海201508 [2]复旦大学附属眼耳鼻喉科医院眼科,上海200031

出　　处：《中国眼耳鼻喉科杂志》2020年第1期21-24,共4页Chinese Journal of Ophthalmology and Otorhinolaryngology

基　　金：国家“十三五”重大新药创制专项“抗艾滋病病毒新药临床评价技术平台建设”项目(2017ZX09304027)

摘　　要：目的提高对获得性免疫缺陷综合征(AIDS)患者眼部卡波济肉瘤(KS)的认识及诊断处理能力。方法回顾系列病例研究。回顾分析10例AIDS并发KS患者的眼部临床表现及其治疗随访结果。结果10例患者均为汉族男性;年龄21~71岁,平均(38.60±15.66)岁;病程10 d^7个月,平均(2.68±2.41)个月。CD4^+T淋巴细胞2~348个/μL,平均(62.30±105.86)个/μL。临床表现:眼睑合并结膜KS4例、结膜KS 4例、眼睑KS 2例。眼睑KS表现为紫黑色局部结节,质韧,边界不清,无移动性,无压痛;结膜KS呈暗红色,片状。仅1例为单纯眼部KS,余9例均为全身多发性KS,累及皮肤、口腔、淋巴结、肺、肝、心包等。治疗:1例单纯眼部睑结膜KS未合并其他部位肿瘤患者行手术切除,高效抗逆转录病毒治疗(HAART),未行化学治疗(简称化疗),观察1年未复发;余9例均给予HAART和多柔比星脂质体或紫杉醇化疗。2例治疗过程中全身衰竭死亡,8例患者随访8~19个月,平均(12.50±4.28)个月,眼部病变6例完全缓解,2例部分缓解。结论随着HIV/AIDS感染日益增多,汉族人种AIDS患者KS发病逐渐增多,且多为多器官累及。HAART合并化疗可提高患者眼部病变缓解率。Objective To improve the understanding and diagnosis and treatment of Kaposi’s sarcoma(KS)in the eyes of patients with acquired immunodeficiency syndrome(AIDS).Methods It′s a retrospective,continuous case series study.Ocular clinical features and follow-up results of 10 patients with AIDS-KS were analyzed.Results The 10 patients were all Han males with age ranged from 21 to 71 years,durations of disease from 10 days to 7 months.The means of CD4^+T-lymphocyte counts of the 10 patients were(62.30±105.86)/μL.The most commonly manifestations are skin and mucous membrane lesions in 10 cases.Eyelid lesions appeared as purple-black raised lumps and conjunctiva lesions appeared as purple-red plaques.Only ocular KS was found in 1 patient and multiple KS in other 9 patients involving skin,mouth,lymph node,lung,liver and pericardium.The patient with only ocular conjunctiva KS underwent surgical treatment and highly active anti-retroviral therapy(HAART).The patient was followed up for 1 year and there was no relapse.The other 9 patients received chemotherapy of doxorubicin liposome or paclitaxel and HAART therapy.Two patients died of systemic failure during treatment.Eight patients had been followed up from 8 to 19 months and 6 patients had obtained complete remission,2 patients had partial remission.Conclusions With the increasing of HIV infection,the incidence of AIDS-KS is increasing in Han Chinese.It most involves multiple organs.HAART and chemotherapy can improve the chance of remission rate of ocular lesions.

关 键 词：获得性免疫缺陷综合征 卡波济肉瘤 临床表现 

分 类 号：R512.91[医药卫生—内科学] R738.6[医药卫生—临床医学] R771.3