HIV/AIDS合并中枢神经系统病变临床分析  

Clinical analysis of HIV/AIDS with central nervous system diseases

作　　者：王曦[1] 李侠 吕正超 李玉叶[2] WANG Xi;LI Xia;LV Zhengchao;LI Yuye(Affiliated Hospital of Infectious Diseases,Kunming Medical University,Kunming 650301,China;Dermatology Department,the First Affiliated Hospital,Kunming Medical University,Kunming 650000,China)

机构地区：[1]昆明医科大学附属传染病医院,云南昆明650301 [2]昆明医科大学第一附属医院皮肤科,云南昆明650000

出　　处：《皮肤病与性病》2023年第3期157-160,共4页Dermatology and Venereology

基　　金：云南省防治艾滋病局项目;云南省“万人计划”名医专项(YNWR-MY-2018-039);云南省皮肤与免疫性疾病临床医学中心(ZX2019-03-02)

摘　　要：目的了解HIV/AIDS合并中枢神经系统病变患者的临床特点,为改善患者预后、提高生存率提供依据。方法以2016年7月~2020年5月昆明医科大学附属传染病医院感染一科收治诊断为HIV/AIDS合并中枢神经系统病变的所有患者为研究对象,收集患者的流行病学信息及病例资料,建立Excel数据库,采用SPSS17.0软件对数据进行分析。结果共有92例HIV/AIDS合并中枢神经系统病变患者纳入本次研究,其中合并隐球菌性脑膜炎占38.05%,结核性脑膜炎占29.35%,弓形虫脑病占13.04%,进行性多灶性白质脑病占7.62%,脑梗塞占6.53%,HIV相关性脑炎占2.17%,鸟分枝杆菌脑膜脑炎占1.08%,病毒性脑膜炎占1.08%。患者CD4^(+)T细胞计数范围在10~838个/μL,中位数86.50个/μL,81.52%的患者CD4^(+)T细胞计数≤200个/μL,55.43%的患者CD4^(+)T细胞计数≤100个/μL。总病死率为21.74%,HIV/AIDS相关中枢神经系统各病种的病死率无统计学差异(P=0.268),不同CD4^(+)T细胞计数患者病死率无统计学差异(P=0.379)。结论HIV/AIDS合并中枢神经系统病变患者病死率高,应注意监测低CD4^(+)T细胞群体神经系统症状,及时诊治提高患者生存率,改善预后。Objective To understand the clinical characteristics of HIV/AIDS complicated with central nervous system diseases,and to provide basis for improving the prognosis and survival rate of patients.Methods From July 2016 to May 2020,all patients diagnosed as HIV/AIDS complicated with central nervous system disease whose nature remained to be determined in Department of infection,Infection Disease Hospital Affiliated to Kunming Medical University were enrolled,and the epidemiological information and case data of patients were collected.An Excel database was established and SPSS17.0 software was used to analyze the data.Results A total of 92 patients with HIV/AIDS complicated with central nervous system diseases were enrolled,including 38.05%with cryptococcal meningitis,29.35%with tuberculous meningitis,13.04%with toxoplasmosis encephalopathy,7.62%with progressive multifocal leukoencephalopathy,6.53%with cerebral infarction,2.17%with HIV-associated encephalitis,1.08%with Mycobacterium avium meningoencephalitis,and 1.08%with viral meningitis.CD4 T cell counts ranged from 10/μL to 838/μL,with a median of 86.50/μL,CD4^(+)T cell counts≤200/μL in 81.52%of patients,and CD4^(+)T cell counts≤100/μL in 55.43%of patients.The overall mortality rate in this group was 21.74%,there was no significant difference in mortality between different diseases of central nervous system related to AIDS(P=0.268),and there was no significant difference in mortality between patients with different CD4^(+)T cell counts(P=0.379).Conclusion HIV/AIDS patients with central nervous system diseases had high mortality.Attention should be paid to monitoring the neurological system symptoms of low CD4^(+)T cell population,timely diagnosis and treatment to improve the survival rate and prognosis of patients.

关 键 词：HIV/AIDS 中枢神经系统病变 临床分析 

分 类 号：R512.91[医药卫生—内科学]