611例艾滋病病人合并真菌感染临床与实验室诊断分析  

Clinical and laboratory diagnosis about fungal infection in 611 AIDS

作　　者：班立芳 陈媛媛[1] 孔庆飞[1] 杨萱[1] 李小龙[1] 赵清霞[1] BAN Lifang;CHEN Yuanyuan;KONG Qingfei;YANG Xuan;LI Xiaolong;ZHAO Qingxia(Henan Provincial Infectious Diseases Hospital,Zhengzhou 450015,Henan,China)

机构地区：[1]郑州市第六人民医院河南省传染病医院,郑州450015

出　　处：《中国艾滋病性病》2020年第11期1154-1156,1173,共4页Chinese Journal of Aids & STD

基　　金：国家“十三五”重大科技专项(2017ZX10202101-001-010);河南省医学科技攻关计划项目(201702330);郑州市科技攻关计划项目(141PPTGG318)。

摘　　要：目的探讨河南省传染病医院住院的艾滋病病人合并真菌感染的发生率、临床表现、治疗及转归。方法对2018年1月至2019年7月期间在河南省传染病医院住院的1750例艾滋病合并各种机会性感染病人的病历资料进行回顾性分析。结果1750例艾滋病病人中,合并真菌感染611例,占34.9%。611例病人均有发热、呼吸道症状、消瘦及淋巴结肿大;肝脾肿大99.7%(609例),85.3%(521例)有皮肤和黏膜病变,头痛56.5%(345例),56.0%(342例)贫血,腹泻腹痛48.8%(298例),16.0%(98例)意识障碍。检出的主要病原菌中,念珠菌47.0%(287例),新生隐球菌18.7%(114例),耶氏肺孢子菌14.7%(90例),马尔尼菲篮状菌12.1%(74例),曲霉菌7.0%(43例),巴斯德伊蒙菌0.5%(3例);分别应用氟康唑、两性霉素B、复方甲恶唑、伏立康唑、伊曲康唑等对症治疗,其中478例经治疗后好转。结论艾滋病病人合并真菌感染的发生率较高。重视病原学送检,应及早诊断,及时有效地进行抗真菌治疗和抗病毒治疗。Objective To investigate the incidence,clinical manifestations,treatment and outcome among the AIDS patients infected with fungal in Henan Infectious Diseases Hospital.Methods Data were collected and analyzed retrospectively based on the medical records of 1750 AIDS patients with various opportunistic infections in the hospital from January 2018 to July 2019.Results There were 611 patients(34.9%)had fungal infections out of the 1750 AIDS patients.All of the 611 patients had fever,respiratory symptoms,emaciation and lymph node enlargement.99.7%(609 cases)had hepatosplenomegaly,with 85.3%(521 cases)of skin and mucosal lesions,56.5%(345 cases)of headache,56.0%(342 cases)of anemia,48.8%(298 cases)of diarrhea and abdominal pain,16.0%(98 cases)of disturbance of consciousness.Of the main pathogens detected,candida was 47.0%(287 cases),cryptococcus neoformans 18.7%(114 cases),pneumocystis jirovecii 14.7%(90 cases),talaromyces marneffei 12.1%(74 cases),aspergillus 7.0%(43 cases),and emergomyces pasteurianus 0.5%(3 cases).Drugs of fluconazole,amphotericin B,compound sulfamethoxazole,voriconazole and itraconazole were used for symptomatic treatment,among which 478 cases were improved after treatment.Conclusion The AIDS patients have higher incidence of fungal infection.Attention should be paid to pathogenic examination,early diagnosis,timely and effective antifungal treatment and antiviral treatment.

关 键 词：艾滋病 真菌感染 临床表现 实验室诊断 

分 类 号：R512.91[医药卫生—内科学] R373.9[医药卫生—临床医学]