摘要
目的了解高效抗反转录病毒治疗（HAART）时代,住院艾滋病病毒（HIV）感染者/艾滋病（AIDS）病人（简称HIV/AIDS病人）机会性感染疾病谱的特征和变化。方法回顾性调查并分析2012年1月1日至2015年12月31日,在南宁第四人民医院感染病区的住院HIV/AIDS病人的人口学特征,实验室检查结果,机会性感染、合并疾病及预后等。结果共调查符合标准的住院HIV/AIDS病人6 222例,年龄中位数48岁,共诊断合并疾病19 712例次,其中机会性感染13 802次（70.02%）。细菌性肺炎（44.17%）、肺结核（34.73%）、口腔念珠菌感染（31.36%）、马尔尼菲青霉菌病（17.52%）、肺外结核（16.68%）、真菌性肺炎（14.27%）、肺孢子菌肺炎（8.65%）、巨细胞病毒感染（4.61%）、单纯疱疹（3,57%）、带状疱疹感染（3.23%）为病人住院治疗的主要机会性感染。非HIV相关疾病有电解质紊乱（14.51%）及肝功能异常（10.38%）、高血压及心脏病（7.23%）、乙型肝炎（6.49%）、皮炎（6.28%）等。HIV相关肿瘤有淋巴瘤65例、宫颈癌32例、卡波西肉瘤40例,非HIV相关肿瘤284例。住院期间死亡604例（9.71%）,自动出院608例（9.77%）,平均住院（17±26）日。住院前接受HAART有2 393例（38.46%）,治疗方案主要为拉米夫定（3TC）＋替诺福韦（TDF）＋依非韦仑（EFV）（13.37%）,齐多夫定（AZT）＋3TC＋EFV（11.99%）,AZT＋3TC＋奈韦拉平（NVP）（11.37%）。结论广西南部地区的HIV/AIDS病人住院原因主要为机会性感染,老年男性病人比率高。常见疾病为细菌性肺炎、肺结核、口腔念珠菌感染等,马尔尼菲青霉菌病有地域特色,需加强艾滋病防护知识宣教、早期筛查及纳入HAART。
Objective To understand the characteristics and changes of opportunistic infections in hospitalized patients with HIV/AIDS in HAART era.Methods The demographic characteristics,lab findings,opportunistic infections,complications and prognosis of hospitalized patients in the fourth people’s hospital of Nanning were retrospectively investigated and analyzed from January 1 st,2012 to December 31 th,2015.Results There were 6 222 HIV/AIDS patients during the period in the hospital,and the median age was 48 years old.19 712 case times of complications were diagnosed,including13 802（70.02%）opportunistic infections,with 44.17% of bacterial pneumonia,34.73% of pulmonary tuberculosis,31.36% of oral candidiasis,17.52% of penicillium marneffei,16.68% of extrapulmonary tuberculosis,14.26% of fungal pneumonia,8.65% of pneumocystis pneumonia,4.61% of cytomegalovirus infection,3.57% of herpes simplex and3.23% of herpes zoster.Electrolyte disorders（14.51%）and abnormal liver function（10.38%）,hypertension and heart disease（7.23%）,hepatitis B（6.49%）,dermatitis（6.28%）were the main comorbidities.Common tumors included 65 cases of lymphoma,32 cases of cervical cancer,40 cases of Kaposi’s sarcoma,and 284 cases of non-HIV-related tumors.There were 604（9.71%）deaths and 608（9.77%）patients left voluntarily during hospitalization, with average hospitalization as 17±26 days.2 393（38.46%）patients received HAART before hospital admission and the HAART programme mainly contained 3 TC＋TDF＋EFV（13.37%）,AZT＋3 TC＋EFV（11.99%）,AZT＋3 TC＋NVP（11.37%）.Conclusion The most frequent cause of hospitalization for HIV/AIDS patients in the Southern Guangxi are opportunistic infections,with a high rate of elderly male patients.Penicillium marneffei has geographical features while pneumocystis pneumonia and cytomegalovirus are different from those of the northern region.
作者
韦林华
张彤
吴锋耀
黄绍标
卢祥婵
何琦
陈朝友
WEI Linhua;ZHANG Tong;WU Fengyao;HUANG Shaobiao;LU Xiangchan;HE Qi;CHEN Chaoyou(Division of Infections, Beijing You＇an Hospital, Capital Medical University, Beijing, 100069, China;The Fourth People＇s Hospital of Nanning, Guangxi, Nanning, 530023)
出处
《中国艾滋病性病》
CAS
CSCD
北大核心
2018年第5期454-457,共4页
Chinese Journal of Aids & STD
基金
北京市科委艾滋病重大专项(D141100000314005,D141100000314002)
北京市艾滋病重点实验室(BZ0089)~~
