综合性医院艾滋病患者肺部病变26例临床分析

目的探讨艾滋病患者肺部病变的临床和诊断要点。方法回顾分析我院（综合性医院）2005年1月-2006年12月期间收治26例艾滋病合并肺部疾病的临床资料。结果26例艾滋病合并肺部疾病的发生率为70．27％（26／37），以发热（84．62％）及呼吸系症状为主诉者（76．92％）是常见的首发症状，本组患者首诊入院及拟诊科室多为呼吸内科，且多为医师主动筛查；艾滋病的肺部表现主要为胸部CT呈肺部毛玻璃样改变（GGO），占38．46％，及／或肺炎（23．08％）．以及肺结核（38．46％）。以呼吸道症状入院17例，其中咳嗽咳（黄）痰13例，气促、喘气、呼吸困难11例；以发热消瘦皮疹淋巴结肿大等入院5例；以意识障碍入院2例；以浮肿、腰部不适入院2例。有颅内病变3例，肝硬化1例，淋巴瘤1例，剥脱性皮炎2例，急性肾衰竭1例，败血症及感染2例。口腔霉菌感染2例，猪霍乱沙门菌败血症1例，严重手部感染不愈1例，合并呼吸衰竭6例。结论我国艾滋病患者的肺部病变主要为以胸部CT改变以CGO为特征的肺部弥漫性病变、肺结核及肺部炎症，及时识别艾滋病的肺并发症是延长患者生命的重要手段之一。

Clinical study of pulmonary complications in patients with acquired immune deficiency syndrome of the general hospital.

Objective To explore the clinical and diagnostic key points of pulmonary diseases in patients with acquired immune deficiency syndrome（ AIDS ）. Methods Clinical data of pulmonary complications in 26 cases of hospitalized AIDS from january 2005 to december 2006 in our hospital （ General Hospital ） were analyzed retrospectively. Results The ratio of pulmonary complications in 26 cases of hospitalized AIDS was 70.27 % （ 26/37 ）, their complains were fever （ 84.62 % ） and respiratory system symptoms （ 76.92 % ） which were common and first symptom, department of respiratory medicine was first common department of admitted hospitalization and suspected diagnosis firstly, and the doctors in charge of a case do HIV test of one＇s own accord;pulmonary complications of hospitalized AIDS in our group were pulmonary CT of ground-glass opacity （ GGO, 38.46 % ）, and/or pneumonia（ 23.08 % ）, and pulmonary tuberculosis （ 38.46 % ）. 17 cases with respiratory system symptoms were admitted, which had 13 cases of cough and/or bring up yellow sputum, 11 cases of shortness of breath, asthma, dyspnea ; 5 cases of fever, marasmus, erythra and lymphadenovarix, 2 cases of a hazy conscious, 2 cases of edema and a discomfort pars lumbalis,Accompanied by 3 cases intracalvarium illness, 1 case cirrhosis, 1 case lymphoma;2 cases desquamation dermatitis, 1 case acute kidney failure, 2 cases infection and septicemia, 1 cases pig cholera Salmonella septicemia, 1 cases serious infection of hand, 6 cases acute respiratory failure. Conclusion Pulmonary complications of AIDS in our group are aspect of palmonary CT of GGO, pneumonia, and pulmonary tuberculosis. It is an important means of prolong-life for AIDS patients to timely distinguish pulmonary complications of AIDS.