摘要
目的 探讨广东地区HIV/AIDS患者机会性感染的特点及其与外周血CD4＋T淋巴细胞计数（CD4＋）之间的关系.方法 对762例HIV/AIDS住院患者机会性感染发生情况及其外周血CD4＋进行分析.结果 762例患者中,704例（92.39%）发生机会性感染,共发生感染1428例次,其中真菌、细菌、病毒感染分别占38.38%、36.20%和7.77%.以肺部、口腔、皮肤、消化道感染、败血症及其他全身播散性疾病为主,分别占33.05%、26.89%、10.29%、8.96%、6.58%和9.94%.CD4＋≥2001μ1的患者机会性感染率为75.74%（103/136）,而CD4＋〈200/μl的患者则为96.01%（601/626）,两组比较差异有统计学意义（P〈0.01）.所有的AIDS指征性机会性感染均发生在CD4＋〈200/μl患者,其中81.97%的耶氏肺孢子菌肺炎（PCP）、71.43%的巨细胞病毒（CMV）视网膜炎及所有的隐球菌脑膜炎、播散性隐球菌病、播散性组织胞浆病、播散性鸟型分枝杆菌病（MAC）、播散性青霉病及弓形虫脑病均发生在CD4＋〈50/μ1的患者.结论 广东地区HIV/AIDS患者机会性感染主要病原为真菌、细菌、病毒等,以肺部、口腔、皮肤、胃肠道和全身播散性感染为主.CD4＋水平越低,机会性感染特别是指征性机会性感染越常见,CD4＋对机会性感染发生的预测、预防和早期诊断与治疗有重要的指导意义.
Objective To analyze the characteristics of opportunistic infection （OI） in patients with HIV/AIDS in Guangdong and the relationship between OI and the change in blood CD4＋ T lymphocyte count （CD4＋ ）.Methods Seven hundred and sixty two patients with HIV/AIDS admitted were analyzed. Results Among all the 762 patients, 704 （92.39% ） had more than one kind of OI, with 1428 episodes totally.Etiologically, fungus infection （38.38% ） was most common, followed by bacteria （36.20% ）, and virus （7.77% ） infection. Most OI occurred in the lungs （33.05% ）, mouth （26.89% ）, skin （10.29% ） and gastro-intestine （8.96% ）.Septicemia and other systemic disseminated diseases accounted for 6.58% and 9.94% respectively.The incidence of OI in patients with CD4＋= 200/μ1 （103/136, 75.74%） was significantly lower than that in patients with CD4＋ 〈200/μ1 （601/626, 96.01%）, P〈0.01.All the AIDS defining OI were found in patients with CD4＋ 〈200/μ1 Among them, 81.97% of patients with pneumonia carinii pneumonia （PCP）, 71.43% of patients with cytomegalovirus retinitis and all the patients with cryptococcal meningitis, disseminated cryptococosis, disseminated histoplasmosis, mycobacterium avium intracellular complex （MAC）, disseminated penicilliosis mameffei and toxoplasma cerebritis had the CD4＋ less than 50/ μ1.Conclusions The most common OI in patients with AIDS in Guangdong area are fungi, bacterial and viral infections.Lung, mouth, skin, gastro-intestine and systemic disseminated infections are the most prevalent infections.As the CD4＋ decreased, the incidence of OI especially AIDS defining OI increased. Dynamic detection of CD4＋ will be of great help for the prediction, prevention, early diagnosis and treatment of OI in patients with AIDS.
出处
《中华内科杂志》
CAS
CSCD
北大核心
2010年第8期653-656,共4页
Chinese Journal of Internal Medicine
基金
＂艾滋病和病毒性肝炎等重大传染病防治＂科技重大专项＂十一五＂计划（2008ZX10001-006,2008ZX10001-008）
广州市重大科技攻关项目（2006Z1-E0091）
作者简介
通信作者：唐小平，Email：xtang@21cn．com
