HIV／AIDS首次住院患者机会感染特点及其与CD4之间的关系

目的探讨HIV／AIDS首次住院患者机会感染特点及其与CD4计数的关系。方法对123例首次住院HIV／AIDS患者进行回顾性分析，总结不同CD4水平患者机会感染发生情况。结果123例患者中共发生机会性感染101例（82．1％）。当CD4计数大于200个／ul时，感染率为40．7％（11／27），100—200个／山时为85．7％（12／14），50～100个／ul时为90．0％（18／20），低于50个／山时为96．8％（60／62）。当CD4计数在100个／山以上时，以2个或以下部位感染为主，而低于100个／山时常发生2个或以上部位的感染。常见机会感染有肺孢菌肺炎、肺结核、消化道真菌感染、隐球菌性脑膜炎、弓形虫脑病、带状疱疹和败血症。结论HIV／AIDS首次住院患者机会感染发病率高，多种病原体和多部位感染常见，且随着CD4计数减少，机会感染的发病率、累及部位增加。

Analysis of the characteristics of opportunistic infections in first-hospitalized HIV/AIDS patients and its relationship with CD4 counts

Objective To analyze the characteristics of opportunistic infections （OIs） in first-hospitalized HIV/AIDS patients and its relationship with CD4 counts. Methods 123 first-hospitalized HIV/ AIDS cases were retrospectively analyzed to summarize the characteristics of OIs occurring in patients with different CD4 levels. Results A total of 101 patients（82.1% ） developed OIs in the 123 HIV/AIDS cases. The incidence rate of OIs was 40.7% （11/27） in patients with CD4 counts 〉 200 cells/ul,85.7% （12/14） in those with CD4 counts between 100-200 cells/ul, and 90.0% （18/20） in those with CD4 counts between 50-100 cells/ul. OIs developed in 96.8% （60/62） of the patients with CD4 counts 〈 50 cells/ul. The number of infection sites was mainly 2 or less in patients with CD4 counts 〉 100 cells/V, while 2 or more infection sites were common when CD4 counts 〈 100 cells/ul. Common OIs included pneumocystis carinii pneumonia, pulmonary tuberculosis ,fungal infections in digestive tracts, cryptococcal meningitis,cerebral toxoplasmosis, herpes zoster, and septicemia. Conclusion OIs occurred frequently in firsthospitalized HIV/AIDS patients, being caused by various pathogens with multiple organs involved. With CD4 counts declining,the incidence rate of OIs and the number of infection sites increased.