18例艾滋病合并噬血细胞综合征临床特点分析  

The clinical characteristics of hemophagocytic lymphohistiocytosis in 18 patients with AIDS

作　　者：梁洪远[1] 肖江[1] 樊丽娜 张玲[1] 郜桂菊[1] 杨涤[1] 张福杰[1] 朱冀远 杜娜[3] 赵文莲 赵红心[1] LIANG Hong-yuan;XIAO Jiang;FAN Li-na;ZHANG Ling;GAO Gui-ju;YANG Di;ZHNG Fu-jie;ZHU Ji-yuan;DU Na;ZHAO Wen-lian;ZHAO Hong-xin(Infection Disease Department,Beijing Ditan Hospital,Capital Medical University,100015,China)

机构地区：[1]首都医科大学附属北京地坛医院感染性疾病诊疗中心,100015 [2]呼和浩特市第二医院感染科,010000 [3]吉林大学第一医院感染科,长春130061 [4]昌都市人民医院感染科,854085

出　　处：《传染病信息》2022年第2期141-143,150,共4页Infectious Disease Information

基　　金：北京市医院管理中心“登峰”人才培养计划(DFL20191802);北京市医院管理中心临床医学发展专项“扬帆”计划专项经费支持(ZYLX202126)。

摘　　要：目的 总结AIDS合并噬血细胞综合征(hemophagocytic lymphohistiocytosis,HLH)的临床特点。方法 回顾性分析2009年1月1日—2021年12月31日在北京地坛医院住院的AIDS患者中HLH的发病率、病因、临床特征和预后。结果 在1641例AIDS合并机会性感染或肿瘤患者中,18例患者诊断为HLH,发病率为1.1%。马尔尼菲青霉菌、巨细胞病毒、EB病毒、鸟分支杆菌和结核分支杆菌感染、非何杰金淋巴瘤、卡波西肉瘤是HLH发生的诱因。经过治疗后仍有10例患者死亡,病死率为55.6%(10/18)。结论 AIDS合并机会性感染或肿瘤的患者出现HLH的发病率低、病死率高,容易漏诊、误诊,对于AIDS患者,要警惕HLH的发生。Objective The study is aimed to explore the clinical characteristics of hemophagocytic lymphohistiocytosis(HLH)in AIDS patients with opportunistic infections and malignancies.Methods The prevalence,etiology,clinical features and prognosis of HLH among AIDS patients were studied retrospectively in Beijing Ditan Hospital from January 1,2009 to December 31,2021.Results The prevalence of HLH in AIDS patients with opportunistic infections and malignancies and prevalence was 1.1%,with 18 cases of diagnosed HLH among 1641 AIDS patients.Penicillium Marneffei,Cytomegalovirus,EBV,tuberculosis,Mycobacterium avium complex(MAC),non-Hodgkin lymphoma and Kaposi’s sarcoma was the common causes of HLH.Ten cases(55.6%)died even after receiving corresponding treatment.Conclusions Low prevalence and high mortality rate of HLH were found among AIDS patients with opportunistic infections and malignancies,which might be misdiagnosis and missed,further reminding doctors of occurrence of HLH among these patients.

关 键 词：艾滋病 噬血细胞综合征 噬血细胞作用 机会性感染 回顾性研究 发病率 病死率 预后 

分 类 号：R512.91[医药卫生—内科学]