综合医院内HIV感染者和艾滋病人的临床特征分析

目的探讨HIV感染者和艾滋病患者在综合性医院的疫情趋势和临床特征。方法前瞻性观察2006年～2009年连续4年因症住院的HIV感染者／艾滋病患者的临床表现。结果4年共计133例，男102例，女31例，年龄6～80岁，平均年龄42．58岁。其临床特征为：①近年艾滋病疫情在综合性医院内的发现有逐年增多趋势，50岁以上患者达37．59％。②综合性医院内绝大多数临床科室均已收治HIV感染者或艾滋病患者，内科系统收治病例数占3／4，呼吸内科收治例数占总数的30％，其次有感染科、消化内科、血液科及神经内科等，而外科系统收治病例约总例数的1／4。内科系统收治者绝大多数系艾滋病患者，而外科系统收治者多数系HIV感染者。③其临床表现以肺部疾病为主者占55．24％；其次有神经系统、消化系统和血液系统疾病，约40％的患者多系统同时受累。④单一感染HIV者约60％，40％左右的患者存在乙肝、丙肝及梅毒等二重或多重感染。⑤多数存在轻、中度贫血及不同程度的感染，接近1／4的患者有白细胞和血小板降低；电解质紊乱较常见的有低钙及低钠血症；约30％～40％的患者肝功能受损为转氨酶升高，肾功能受损较少，近半数的患者血清白蛋白降低，27．78％的患者血糖升高，42．1％的AIDS患者CEA高于正常，严重肺部疾患者易发生低氧血症。结论综合性医院支滋病病例报告逐年增多是HIV感染／艾滋病正由高危人群向普通人群蔓延的表现，熟悉和掌握艾滋病在综合性医院内的临床特征，对提高防治艾滋病的水平和控制HIV感染具有重要意义。

Clinical characteristics of patients infected HIV in general hospital: Analysis of 133 cases

Objective To investigate clinical characters of AIDS patients in comprehensive hospital. Methods Clinical characters of AIDS patients in our hospital from 2006 to 2009 were prospectively observed. Results It was sum 133 cases, male 102 and female 31, range of year was from 6 to 78 years old, mean 42.58. the clinical characters were （1） the increased diagnosis of AIDS in our general hospital, and patients over 50 year old had increased 37.59%. （2） The overwhelming majority of clinical departments in general hospital had received AIDS patients, which three fours patients were treaed by medical department, 30% of cases were treated in medical department of respiratory, others in departments of infection, digestive internal, hematopathy and neurology etc; but one fours patients were treated in surgical department. 3） Pulmonary diseases were the major clinical characters of these patients （55. 24%）, others were nerve symptom, digestive tract symptom and blood disease. About 40 % of patients suffer from multisystem diseases simultaneously. （4） About 60% of patients were only infected with HIV, about 40% patients were double or multiple infected with HBV, HCV or syphilis simultaneously. （5）The majority of patients were mild or moderate anemia, and infections. Decreased white blood cell and blood platele were detected in one fourths of patients, there were commoner decreased calcium and sodium in disorder eleetrolyte; about 30 % of raised ALT and 43. 6 % raised AST, but decreased kidney function were fewer; serum albumin near half patients and 27. 78 % of increased blood sugar, 42.1% raised carcinoembryonic antigen （CEA）, patients with serious pulmonary infection take easy place Hypoxemia. Conclusion Increased case reports with AIDS year by year indicated amount of HIV infection was increased. These clinical characters of AIDS are of imporrant significance to prevent HIV infection.