艾滋病相关机会性感染的诊断和临床特点研究

目的研究分析艾滋病机会性感染的临床特点。方法对北京地坛医院2006—2007年度46例住院病人中，诊断为艾滋病相关机会性感染病例的资料进行回顾性分析。总结其发生情况，病原学确定情况以及其临床表现等。结果46例病人各种机会性感染的发生情况如下：结核病17例（36．9％），肺孢子肺炎（PCP）11例（23．91％），巨细胞病毒（CMV）感染9例（19．57％），隐球菌脑膜炎5例（10．87％），进展性多灶性脑白质病变（PML）3例（6．52％），鸟分枝杆菌（MAC）感染1例（2．17％）。病原学确诊率分别是结核病29．4％，PCP0，CMV感染0，隐球菌脑膜炎、PML、MAC均100％。所有病人的平均CD。细胞计数为47．3／μl，明显低于200／μl及正常水平500／μl。病人均处于免疫功能缺陷状态。结论艾滋病病人的机会性感染病因及临床表现复杂多样，临床诊断困难。需要通过特异性的检查提高机会性感染的病原学诊断率。经验性治疗有助于诊断。

Study on diagnosis and clinical features of AIDS-related opportunistic infections

Objective To study and analyze clinical features of opportunistic infections in AIDS patients. Methods Forty six cases of AIDS related opportunistic infections hospitalized in Beijing Ditan Hospital from 2006 to 2007 were retrospectively analyzed. The morbidity of OIs, pathogen confirmation status and clinical features of AIDS pa- tients were included. Results Among the 46 cases, the incidence of different OIs was as follows. TB was detected in 17 cases （36.9 % ）, PCP in 10 cases （21.7 %）, CMV infections in 8 cases （ 17.3 % ）, cryptomenigitis in 5 cases （10.8%）,PML in 3 cases （6.5%）,and MAC in 1 case （2.1%）. The rates of pathogenic diagnosis was 9.4% for TB, 0% for PCP and CMV infection, 100% for cryptomenigitis, PML0 and MAC. The mean CD4 cell count of all patients was 47.3/μl which was much lower than 200/μl and the normal value of 500//μl. All the patients were immuno deficient. Conclusions The AIDS patients have broad OIs spectrum and their clinical features are compli- cated.. The diagnosis of OIs is difficult. To increase the possibilities of pathogenic diagnosis, specific tests will be developed. Empiric treatment will be useful for the diagnosis.