【摘要】 目的:探讨我院HIV/AIDS患者住院的原因,机会性感染的疾病谱及机会性感染发生与CD4+T淋巴细胞的关系。方法:收集2005年1月~2013年8月在我院住院的109例次HIV/AIDS病人,就其临床及实验室资料进行回顾性分析。结果:109例次HIV/AIDS住院患者,因服用抗病毒药物出现严重副反应而住院15例次;因机会性感染而住院83例次。机会性感染以消化系统和呼吸系统的疾病为主,前三位机会性感染为细菌性呼吸系统感染30例次、念珠菌感染28例次、结核菌感染15例次;机会性感染的发生和CD4+T淋巴细胞计数有密切关系;细菌、念珠菌、结核菌在CD4+T淋巴细胞的每个区段都可发生,但CD4T淋巴细胞越低,念珠菌感染越高且重,有时波及胃、肠、皮肤和四肢,而结核菌感染则症状不典型,伴有全身或纵膈淋巴结肿大。PCP仅在CD4+T淋巴细胞<200个/mm3发生。CD4+T淋巴细胞在350~500个/mm3之间有机会性感染出现。结论:机会性感染和抗病毒药物副反应是患者就医住院的主要原因;CD4+T淋巴细胞<500个/mm3即应启动抗病毒治疗。更多还原

【Abstract】 Objective: To analyze the causes for HIV/AIDS patients required hospitalization and investigate the spectrum of disease in the opportunistic infection as well as the relationship between the opportunistic infection and CD4+positive T-lymphocyte count. Methods: The clinical data and laboratory findings were retrospectively examined in 109 patients with HIV / AIDS infection undergone therapy on hospitalization basis in our hospital between January2005 and August 2013. Results: Of the 109 patients,15 required hospitalization due to serious adverse effects from administration of antiviral drugs and 83due to the opportunistic infections that were involved in diseases of either digestive or respiratory system,including bacterial infection with the respiratory system( n = 30),candidiasis( n = 28) and infection of mycobacterium tuberculosis( n = 15). The opportunistic infection was strongly related to CD4+Tlymphocyte count,and the infection from bacterium,candida or mycobacterium tuberculosis had occurred regardless of CD4+cell count. Yet,lower CD4+T-lymphocytes led to severer infection from candida and more involvement of the stomach,intestines,skin and limbs. The patients infected by mycobacterium tuberculosis were characterized by atypical symptoms and with enlargement of systemic or mediastinal lymph nodes. Pneumocystsis carinii pneumonia occurred at the count of CD4+T-lymphocyte lower than 200 cells / mm3,and opportunistic infection at 350 ~500 cells/mm3. Conclusion: Hospitalization requirement is generally associated with opportunistic infection and adverse effects from antiviral medication for patients with HIV / AIDS infection,and administration of the antiviral drugs is necessary and rational if CD4+T-lymphocyte count is lower than 500 cells / mm3.更多还原