HIV相关性血小板减少性紫癜的临床疗效  

Study on the clinical efficacy of HIV-related thrombocytopenic purpura

作　　者：柯迎春[1] 蔡卫平[1] 郭朋乐 敖云龙 郑乃青 陈谐捷[1] KE Yingchun;CAI Weiping;GUO Pengle;AO Yunlong;ZHENG Naiqing;CHEN Xiejie(Department of Infectious Diseases,Eighth People's Hospital,Guangzhou 510060,China)

机构地区：[1]广州医科大学附属市八医院感染病中心,广州510060

出　　处：《中国艾滋病性病》2021年第7期745-747,共3页Chinese Journal of Aids & STD

基　　金：国家科技重大专项(2017ZX10202101-005-004);“十三五”国家科技重大专项(2018ZX10302104-001-007)。

摘　　要：目的观察HIV相关性血小板减少性紫癜的临床特点及ART的临床疗效。方法回顾性调查2013-2020年在市八人民医院感染病中心住院治疗的HIV相关性血小板减少性紫癜且至少随访观察1年以上患者,根据资料记载不同医生的不同治疗方案,将患者分为3组,将这些患者分为仅予ART组(A组)、ART+激素组(B组)、ART+激素+丙种球蛋白组(C组),收集一般情况、临床表现、血常规、血小板、CD4细胞计数、骨髓涂片、腹部B超结果、治疗方案。结果三组患者CD4细胞<50个/μL 2例,50~200个/μL 15例,200~500个/μL 12例,500个/μL以上3例。CD4细胞计数和CD4/CD8比值较治疗前有所上升,但均无统计学差异(P>0.05)。三组治疗后血小板均较治疗前明显上升,治疗前后差异均有统计学意义(P<0.05);三组获得完全反应(CR)率和血小板恢复正常时间差异均无统计学意义(χ^(2)=2.49,P=0.28)。结论HIV相关性血小板减少性紫癜发生与CD4细胞计数水平无明显关系。HIV相关性血小板减少性紫癜单用ART可取得良好疗效,长期ART可以使病情稳定与缓解。Objective To observe the clinical features of HIV-related thrombocytopenic purpura and the clinical efficacy of antiretroviral therapy(ART).Methods Retrospective investigation,between 2013 to 2020,patients with HIVrelated thrombocytopenic purpura from Eighth People's Hospital in Guangzhou were selected and followed up for at least one year.Data concerning treatment plans made by different doctors were recorded.Patients were divided into groups as A)only using hormones and gamma globulin in the ART group,B)ART+hormone,and C)ART+hormone+gamma globulin.Data regarding general conditions,clinical manifestations,blood routine,platelets,CD4^(+)T lymphocyte counts(CD4 cells for short),bone marrow smears,abdominal B-ultrasound results,and treatment plan for these patients,etc.,were gathered.Results Among the three groups,2 cases had CD4 cells<50 cells/μL,15 cases had 50-200 cells/μL,12 cases had 200-500 cells/μL and 3 cases had more than 500 cells/μL.CD4 cells and CD4^(+)/CD8+increased compared with before treatment,but with no statistical differences(P>0.05).After treatment,the platelets of all three groups were significantly higher than before and with significant differences before and after treatment(P<0.05);No significant differences were seen in the complete response(CR)rate and platelet recovery time of the three groups(P>0.05).Conclusion No significant relationship was noticed between the occurrence of HIV-related thrombocytopenic purpura and the count of CD4 cells.ART alone can achieve a good curative effect in HIV-associated thrombocytopenic purpura,and long-term ART can stabilize and relieve the disease.

关 键 词：艾滋病病毒 血小板减少性紫癜 抗病毒治疗 疗效 

分 类 号：R373.9[医药卫生—病原生物学]