11例汉族艾滋病相关性卡波西肉瘤病人的临床特点

目的回顾性分析广州八院收治的汉族艾滋病相关性卡波西肉瘤病人的临床、病理特点及诊治情况,总结其临床特点和诊治经验。方法回顾性分析2007年1月至2013年1月住院诊治的11例汉族艾滋病相关性卡波西肉瘤病人的临床资料。结果 111例卡波西肉瘤病人中男性10例（90.9%）,中位年龄31岁（25～38岁）,治疗前CD＋4T淋巴细胞计数中位数47个/μL（9~497个/μL）;2所有病人均合并有感染,其中72.7%为肺部感染,6例病人存在2种及以上机会性感染;3所有病人均有皮肤损害,其中4例起始于下肢,其他还包括颌下、躯干、腹股沟、足底、鼻梁、手指（各1例）;1例女性病人以阴唇为首发皮损部位;4病理分型以斑点型（4例）和结节性（5例）为主;511例病人中有3例在发现卡波西肉瘤前已启动抗病毒治疗（ART）,经过ART后病人病情均好转;余8例在发现卡波西肉瘤后启动ART,其中6例病人因合并多种机会性感染或播散至内脏（3例）死亡,另外2例经治疗后好转。结论汉族人艾滋病相关性卡波西肉瘤好发于中青年男性,病人基础免疫功能低下,均有不同程度的皮损表现,多数并发机会性感染,病理分型以斑点型和结节性多见,尽早ART有助于改善预后。

The clinical features of 11 cases of AIDS-related Kaposfs sarcoma in Han Chinese people

Objective To review and analyze the clinical characteristics,pathological type and clinical experience of AIDS-related Kaposi＇s sarcoma in Han Chinese people.Methods There were 11 cases of Han Race with AIDS-related Kaposi＇s sarcoma recruited from January 2007 to January 2013,and the clinical data were retrospectively analyzed.Results 110 of the 11 recruited cases were male（90.9%）.Median age was 31 years old and pre-treatment CD＋4T cell count was 47（9-497）cells/μL;2 All patients had co-infection,of which the most common was lung infection（72.7%）,and 6patients had two or more opportunistic infections;3 All patients had skin lesions,with four cases starting from lower limbs,and others including jaw,torso,groin,foot,nose and fingers（1case）.One case started form labia;4 The main pathological types of Kaposi＇s sarcoma were spot type（4cases）and nodular type（5cases）;5 Among the 11 patients,3started anti-retroviral therapy（ART）before diagnosis of Kaposi＇s sarcoma and got better after ART.The remaining 8cases were diagnosed after ART,among which six were dead because of multiple opportunistic infections or spread to internal organs（3cases）,and 2were improved after treatment.Conclusion AIDS-related Kaposi＇s sarcoma occurs usually in young man with poor immunity status.All patients have skin lesions and mostly complicated with opportunistic infections.Early HARRT treatment may improve prognosis