摘要
目的对社区类获得性免疫缺陷(AIDS)综合征(阴性HIV)"患者"进行病因探索。方法采用定性系统分析筛检国内外相关综合征报道病例,探索类AIDS综合征"患者"临床特征可能的聚类属性;通过现况调查掌握"患者"人群的一般特征和临床特征。结果定性系统分析显示,目前在世界范围,与类AIDS综合征(阴性HIV)"患者"相似的疾病有2种,即CD4+T淋巴细胞缺陷综合征(ICL)和非结核分枝杆菌感染(NTM感染);通过174例网络调查和52例现场观察,发现"患者"人群以男性为主,青、中年为主;在国内分布地区广泛;主诉症状涉及呼吸道、消化道、皮肤、肌肉、骨骼和神经系统;根据症状特点,病程有急性期和稳定期之分;群体症状及体征为:淋巴结部位肿胀感、骨痛、肌肉"跳"(痛)、淋巴结节、皮肤结节(皮疹)、舌苔白厚、关节弹响、皮肤干燥;52例"患者"检测发现CD4+T淋巴细胞<500/μL 17例(32.69%)、CD4/CD8比值异常16例(30.77%)、干扰素-γ抗体阳性17例(36.69%)和PPD阳性39例(++～+++,75.00%);高危险性行为是可疑的暴露因素之一。结论类AIDS综合征(阴性HIV)"患者"现象不能完全用心理因素予以解释,其呈现的临床特征有明显的一致性和规律性,亟待开展深入研究进行分析。
Objective To investigate the possible causes of AIDS-related complex （HIV negative） in community population. Methods Qualitative systematic analysis was used to screen the cases with AIDS-related complex （HIV negative） that had been reported. The possible clustering types of the clinical features of AIDS-related complex were explored based on a cross-section study that had been conducted to observe the personality and clinical features of the cases with AIDS-related complex. Results The qualitative systematic analysis suggested that the idiopathic CD4＋ T lymphocytopenia （ICL） and infection of nontuberculosis mycobacteria （NTM） had similar characteristics with AIDS-related complex （HIV negative）. Through network investigation of 174 cases and field observation of 52 cases, the data showed that the AIDS-related complex population came from different areas of China, and was dominated by young and middle-aged male patients. The complained symptoms involved respiratory tract, gastrointestinal tract, skin, muscle, skeleton and nervous system. The clinical course could be divided into an acute period and a stable period. The special symptoms are swollen lymph nodes, snapping joint, osteodynia, muscle throbbing pain, skin nodules （rash）, greasy tongue coating and dry skin. The CD4＋ T lymphocytes 〈500/μL （32.69%）, the abnormal ratio of CD4/CD8 （30.77%）, the positive antibody of IFN-γ （36.69%） and positive PPD （＋＋ to ＋＋＋, 75.00%） were detected in the 52 cases, and high risk sexual behavior was a suspected exposure factor. Conclusion The AIDS-related complex （HIV negative） in population can not be completely explained by mental disorder. The clinical features have obvious consistency and regularity, and need further study to verify.
出处
《第三军医大学学报》
CAS
CSCD
北大核心
2013年第5期369-375,共7页
Journal of Third Military Medical University
