不同基线CD4^+T细胞水平抗逆转录病毒治疗HIV/AIDS患者合并机会性感染的临床特点  

Clinical characteristics of HIV/AIDS patients with opportunistic infection different baseline levels of CDT cells receiving antireviral therapy

作　　者：叶韦玮[1] 吴霜[1] 陈永薪[1] 楼莲青[1] 陶兴飞[1] YE Wei-wei;WU Shuang;CHEN Yong-xin;LOU Lian-qing;TAO Xing-fei(Central Hospital of Yiwu City,Yiwu,Zhejiang 322000,China)

机构地区：[1]义乌市中心医院感染科,浙江义乌322000

出　　处：《中华医院感染学杂志》2020年第15期2296-2300,共5页Chinese Journal of Nosocomiology

基　　金：浙江省科研基金资助项目(2018AN162)。

摘　　要：目的探究不同基线CD4^+T细胞水平接受抗逆转录病毒治疗(Antiretroviral therapy,ART)的HIV/AIDS患者与合并机会性感染(Opportunistic infections,OIs)的关系。方法选取2018年9月-2019年5月于义乌市中心医院感染科接受治疗的126例HIV/AIDS患者,经筛选后收集其基线CD4^+T细胞计数结果,随后进行每隔3个月的随访调查并对其OIs的情况进行记录分析。结果126例HIV/AIDS患者共发生OIs 118例次,发生率93.65%;以口腔感染、结核菌感染、病毒性腹泻发生为主;基线CD4^+T细胞数量>500个的患者OIs发生率为38.46%,低于其他各组(P<0.05),基线CD4^+T细胞数量<50个的患者OIs发生率为160.00%,基线CD4^+T细胞水平的越低,OIs的发生率越高(P<0.05);相同治疗时间,基线CD4^+T细胞水平越低,OIs发生的例数越多(P<0.05);各基线CD4^+T细胞水平以肺、口腔、胃肠道的部位感染为主,病原类型以细菌感染为主;基线CD4^+T细胞>500的患者各数量感染人数均为最少,基线CD4^+T细胞水平越低,患者出现OIs的部位越多(P<0.05)。结论基线CD4^+T细胞水平与HIV/AIDS患者发生OIs密切相关,尽早开始ART治疗对减少OIs的发生,提升HIV/AIDS患者的生存质量,减少疾病的传播具有重要价值。OBJECTIVE To explore the relationship between different baselines of CD4^+T cells and the incidence of opportunistic infection in HIV/AIDS patients receiving antiretroviral therapy.METHODS A total of 126 HIV/AIDS patients who were treated in the department of infectious diseases of Yiwu Central Hospital from September 2018 to May 2019 were recruited.The count of CD4^+T cells in all subjects were detected for the and followed up every 3 months.RESULTS A total of 118 cases of opportunistic infection occurred in 126 HIV/AIDS patients,the incidence rate was 93.65%.Oral infection,tuberculosis infection,and viral diarrhea occurred more frequently.The incidence of OIs in patients with baseline of CD4^+T cells>500 was only 38.46%,which was significantly lower than that in other groups(P<0.05).The incidence of OIs in patients with baseline level of CD4^+T cells<50 was 160.00%.The lower the baseline level of CD4^+T cells was,the higher the incidence of OIs occured(P<0.05).Under the same duration of the treatment,the lower the baseline level of CD4^+T cells was,the more OIs occurred(P<0.05).The main infection occurred in the lung,oral cavity and gastrointestinal tract in the group of different levels of CD4^+T cells.The main strains of the pathogens were bacteria,followed by the virus and fungi.The number of patients with baseline CD4^+T cells>500 was the least.The lower the baseline level of CD4^+T cell was,the more patients had OIs(P<0.05).CONCLUSION Baselines of CD4^+T cell level were closely related to OIs in HIV/AIDS patients.Early initiation of ART therapy was of great value in reducing the incidence of OIs,improving the quality of life of HIV/AIDS patients,and reducing the spread of disease.

关 键 词：CD4 获得性免疫缺陷病毒 艾滋病 机会性感染 基线水平 

分 类 号：R512.91[医药卫生—内科学]