【摘要】 目的 :探讨艾滋病并发真菌感染患者的临床特点、药物治疗及预后情况。方法 :对 2 6例艾滋病并发真菌感染患者进行临床及药物治疗分析。结果 :男女发病基本一致 ,以青壮年为主。艾滋病病毒 (HIV)感染途径主要为性传播途径 19例 (73 .1% ) ,临床主要以发热 (92 .3 % )、咳嗽 (5 3 .8% )、腹泻 (3 8.5 % )为主要症状 ,且多反复发作 ,持续时间 >1个月。深部真菌感染 2 5例 (96.2 % ) ,其中白念珠菌 2 1例 (80 .8% ) ,马尔尼菲青霉菌 3例 (11.5 % ) ,克鲁维酵母菌 1例(7.7% )。 2 6例患者病死率为 19.2 % ,马尔尼菲青霉菌感染 3例均生存。 2 6例患者均采用抗真菌治疗 ,其中 2 2例联合应用高效抗逆转录病毒疗法 (HAART)治疗 ,治疗前CD+ 4为 (6.0 7± 5 .78) % ,治疗 1个月后CD+ 4为 (10 .63± 7.0 0 ) % ,较治疗前明显升高 (P <0 .0 5 ) ;HIVRNA(取对数值 )治疗前为 (4 .81± 0 .5 0 )拷贝·mL 1 ,治疗 1个月后为 (2 .70± 0 .0 0 )拷贝·mL 1 ,较治疗前明显降低 (P <0 .0 5 )。且联合使用HAART及抗真菌治疗患者的病死率明显低于单用抗真菌治疗患者的病死率(P <0 .0 5 )。结论 :真菌感染是艾滋病患者最常见的并发症 ,青壮年发生真菌感染尤其是马尔尼菲青霉菌感染 ,应考虑艾滋病 ,及早联合进行HAART及抗真菌治?更多还原

【Abstract】 Objective:To study the clinical features, drug treatment and prognosis of patients with AIDS complicated by fungous infection. Methods:The clinical data and drug treatment of 26 patie nts with AIDS complicated by fungous infection were subjected to statistical ana lysis. Results:These patients were admitted into our hospital f rom January 1997 to October 2003. Most patients were young people or those in th e prime of life. The numbers of male and female patients were nearly identical. Nineteen (73.1%) out of the 26 patients contracted HIV infection via sexual behaviour. The major clinical manifestations were fever (92.3%), cough (53.8%)an d diarrhea (38.5%), recurring usually in repeated episode over the time of 1 mon th. Among the 25 (96.2%) cases of deep fungous infections, 21 (80.8%) suffered f rom candidiasis albicans and 3 (11.5%) were ill with penicilliosis marneffei. Th e case-fatality rate of the 26 patients was 19.2%. The 3 patients with penicill iosis marneffei survived. All of the 26 patients were treated with antifungal ag ents, 22 patients were treated with antifungal agents in combination with highly active antiretroviral therapy (HAART). After the one-month treatment, the CD + 4 cell percentage was evidently increased from the pretreatment value (6.0 7±5.78)% to (10.63±7.00)% (P<0.05)while the logarithm value of HIV RN A was dramatically dropped from the pretreatment level of (4.81±0.50) copy·mL -1 to (2.70±0.00) copy·mL -1(P<0.05). The case-fatality rat e of patients treated with antifungal agents in combination with HAART was defin itely lower than that of those treated with antifungal agents alone. Conclusion:Fungous infection is the most common complica tion of AIDS patients. Young patients or those in the prime of life should be s uspected of being ill with AIDS if they are shown to contract deep fungous infec tions in particular penicilliosis marneffei. Early treatment with antifungal age nts in combination with HAART has been shown to lower the case-fatality rates.更多还原