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艾滋病合并细小病毒B19感染致纯红细胞再生障碍性贫血2例患者临床特点分析

Clinical characteristics of 2 cases with pure erythrocyte aplastic anemia caused by AIDS with parvovirus B19 infection
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摘要 目的分析2例与细小病毒B19感染有关的纯红细胞再生障碍性贫血艾滋病患者的临床资料。总结其治疗过程、诊疗效果,并进行相关文献总结。方法对在新疆医科大学第一附属医院感染性疾病中心进行抗病毒治疗的2例纯红细胞再生障碍性贫血的艾滋病患者,对其发病、治疗、相关检查、治疗效果等进行统计,总结相关点,分析不同点。结果 2例患者,初始抗病毒治疗方案均为依非韦伦+拉米夫定+替诺福韦酯;治疗3月时更换为克力芝+拉米夫定+替诺福韦酯;在诊断为纯红细胞再生障碍性贫血后,给予强的松60mg,1次/d口服,同时加用免疫球蛋白40mg/(kg·d)静脉输注治疗,疗程5~7d/次,并给予对症治疗,治疗8月后,2例患者血红蛋白分别升至157g/L和120g/L,CD4^+T细胞计数分别升为110~个/μl及310个/μl,B19DNA降至1.16×10~2拷贝/ml和2.16×10~6拷贝/ml。结论纯红细胞再生障碍性贫血在普通人群中发病率偏低,同时合并艾滋病更加少见。细小病毒B19感染是纯红细胞再生障碍性贫血的发病原因之一,而且在免疫缺陷患者中,细小病毒B19的感染率可能更高。该2例细小病毒B19感染后继发纯红细胞再生障碍性贫血的艾滋病患者,三种疾病可以互为因果关系,针对任何一个疾病不进行正规治疗,均会导致患者病情的加重。因此,在治疗过程中需要兼顾每一种疾病,才能达到疾病总体全面的恢复。
作者 潘珂君 邓泽润 买买提艾力.吾布力 鲁晓擘 PAN Ke-jun;DENG Ze-run;Maimaitiaili Wubuli;LU Xiao-bo(Infection Department of Xinjiang Medicine University,Wulumuqi,Xinjiang 830054,China)
出处 《中国病毒病杂志》 CAS 2018年第5期375-377,共3页 Chinese Journal of Viral Diseases
关键词 纯红细胞再生障碍性贫血 HIV 艾滋病 细小病毒B19 感染 抗病毒治疗 Pure red cell aplastic anemia HIV AIDS Parvovirus B19 Infection Antiviral therapy
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