解读艾滋病机会性感染

<正>什么是机会性感染所谓机会性感染就是当人体的免疫功能下降时,原本已经寄生在人体中的一些非致病菌可能造成的疾病,或者是对致病菌的易感性增加所造成的感染。这种感染,对于一个具有正常免疫功能的人来说,不会造成疾病状态;而对于一个HIV感染者,尤其对于到了艾滋病期的病人来说,因其免疫功能已严重受损,无法维持正常的免疫状态以抵抗病菌的侵袭,因此极易发生对于正常人来说罕见的感染。由于该类病     

艾滋病病人的机会性感染

机会性感染是指一些侵袭力较弱、致病力也较低的病原微生物。当人体患病而处于抗病能力低下的时期,也即免疫功能降低时,则为这类病原体造成了感染的机会,导致各种感染的发生,称为机会性感染。 在正常情况下,由于人体有皮肤、粘膜的屏障和免疫系统,当机体受到病原体侵袭时会迅速发挥屏障和免疫系统各部门的识别、排除和消灭的作用,尤其是对侵袭力和致病力较弱的病原体。故而,机会性感染在人类疾病中很少出现。但是,当艾滋病病毒侵入人体以后,病毒专门选择了T_4淋巴细胞(即辅助性T淋巴细胞,属于免疫细胞)为其自身复制繁殖的场所。T_4淋巴细胞表面有一种分子,其结构很易与艾滋病病毒外壳上的特殊糖蛋白相结合。进入人体内     

艾滋病与机会性寄生虫感染

艾滋病即获得性免疫缺陷综合征(Acquired Immune Deficiency Syndrome,AIDS),1981年在美国首次被发现,至1986年11月14日,全世界共报告AIDS 34448例。其中美洲29273例、欧洲3694例、非洲1069例、亚洲68例。目前已有40～20％病例死亡,随着发病时间的推移,病死率逐步增加,可     

机会性寄生虫感染与艾滋病

艾滋病（ＡＩＤＳ）在过去对我国大陆地区许多人来说比较陌生，但是这个人类目前最可怕的病魔已威胁着全球，我国大陆地区也不例外。据１９９８年１１月２４日ＷＨＯ报告指出：全球ＡＩＤＳ病毒感染者累计已达３３４０万，每分钟世界新增感染者１１人。我国大陆地区近年Ａ...     

艾滋病患者患机会性感染的住院费用

目的 分析AIDS患者因患机会性感染而住院的治疗费用情况.方法 收集2008-2010年某AIDS高流行地区因机会性感染而住院的158例AIDS患者资料,包括患者的基本情况、机会性感染类型、治疗机会性感染等的各项费用;比较分析不同特征患者的各项治疗费用(中位数)的差异.结果 AIDS机会性感染者的住院总费用为2935.7元,其中检查费、化验费、药品费、诊疗费、护理费、床位费分别为132.5、269.0、1485.5、367.3、302.5、264.0元;男性和女性患者的住院总费用分别为4383.1、3418.6元(U=-1.279,P=0.201);汉族和其他民族患者的住院总费用分别为4703.1、3475.9元(U=-1.025,P=0.305);务农、个体经商者、企事业单位、无业患者的住院总费用分别为3429.3、5022.2、6705.5、2396.7元(H=28.633,P=0.000);文盲患者的住院总费用最低,为2590.2元,小学、初中、高中及以上分别为3626.5、4214.3、6865.8元(H=10.828,P=0.013);29岁及以下、30 ～39岁、40～49岁、50岁及以上患者的住院总费用分别为2873.6、4534.3、3077.8、3208.1元(H=1.515,P=0.679);经性途径感染的患者住院总费用(4621.3元)高于经静脉注射吸毒感染患者(3208.6元)(U=-2.588,P=0.010);神经系统疾病患者住院费用最高(5819.7元),呼吸系统疾病、消化系统疾病、皮肤和黏膜疾病分别为4300.8、2806.8、2083.9元(H=15.142,P=0.004).结论 在住院总费用方面,文盲AIDS患者低于其他文化水平的患者,经性途径感染的患者高于经静脉注射吸毒感染患者,神经系统疾病患者高于其他类型疾病患者.     

120例艾滋病机会性感染临床分析

目的根据对艾滋病机会性感染的患者进行临床资料的数据分析,归纳其特点,从而进一步提高对这一疾病的诊疗水平和认识。方法通过分析艾滋病机会性感染患者的临床资料,探讨该病的特点。结果艾滋病机会性感染具有很多特点,多样性、复杂性、难治性。结论艾滋病常见的感染是消化系统和呼吸系统的感染。     

132例艾滋病机会性感染临床特征分析

[目的]分析云南省红河州艾滋病（AIDS）机会性感染的临床特点。[方法]回顾性分析本院1998年6月～2007年6月收治的132例艾滋病病例的临床资料，总结艾滋病机会性感染的临床特点。[结果]132艾滋病病例中，机会性感染结核病84例，占63．6％，真菌感染58例，占40．9％，HIV／HCV合并感染46例，占34．8％，带状疱疹、沙门氏茵感染、致病性大肠埃希杆菌肠炎、金黄色葡萄球菌肺炎、弓形虫脑病亦有发病。[结论]艾滋病机会性感染临床表现复杂多样，结核病是最常见的机会感染，其次是真菌感染，HIV／HCV合并感染率高。     

122例艾滋病机会性感染临床分析

目的通过对艾滋病合并机会性感染患者的临床资料分析,总结其临床特点,提高对艾滋病机会性感染的认识和诊治水平。方法回顾性分析122例艾滋病合并机会性感染患者的临床资料,分析和探讨艾滋病合并机会性感染的临床特点、诊断和治疗。结果艾滋病合并机会性感染具有多样性、复杂性和难治性,以呼吸道和消化道感染多见,随着CD4+T细胞计数的下降,艾滋病合并机会性感染发生的频率增加,发病更严重,病死率更高。结论呼吸系统和消化系统是艾滋病常见的机会性感染,CD4+T细胞计数和临床表现对于指导诊治具有重要意义,诊断上能够早期明确诊断,及时预防和控制各种机会性感染,有利于提高患者生活质量,延长生命。     

艾滋病机会性感染7例临床分析

目的 分析艾滋病的临床特征,以提高对HIV感染的认识,做到早期诊断.方法 用ELISA法和免疫印迹试验,对感染者的血清进行HIV抗体初筛和确认,并对感染者的流行病学、症状和体征及机会性感染特点进行回顾性分析.结果 7例艾滋病患者的传播途经以性传播为主,临床表现具有多样性,发热、咳嗽、消瘦为常见的症状,多部位的机会性感染可见于所有临床已发病的患者.结论 明确艾滋病及其并发症的临床表现有助于做到早期诊断.     

Nutrition care of AIDS patients

Often the complications of the acquired immunodeficiency syndrome (AIDS) have a negative impact on nutritional status. Weight loss and protein depletion are commonly seen among the AIDS population. Though the relationship between disease progression and nutritional status has not been established, maintaining good nutritional status may support response to treatment of opportunistic infections and improve patient strength and comfort. Increased nutrient needs, decreased nutrient intake, and impaired nutrient absorption contribute to malnutrition in AIDS patients. Causes of decreased nutrient intake and absorption may be poor appetite, oral and esophageal pain, mechanical problems with eating, and gastrointestinal complications (diarrhea and malabsorption). Causes of these impediments to maintaining nutritional status are discussed, and suggestions to overcome them are given. Dietitians working with AIDS patients need to understand how the complications of the disease might affect nutritional status so that strategies for nutrition treatment can be developed. Nutrition care of AIDS patients requires that dietitians and their support personnel provide supportive, nonjudgmental care. The patients should be included in decision making regarding their nutrition care. Caring for AIDS patients in the community and through home care agencies represents an area in need of the expertise of a dietetics professional.     

Treatment of AIDS patients with zidovudine

During 20 months 49 AIDS patients treated with zidovudine were followed prospectively. The 12-month cumulative probability of survival was 73% and the 18-month probability of survival was 51%. The probability of survival was significantly higher when, at the start of therapy, the Karnofsky score was 70 or higher (p less than 0.001) or the CD4 cell count was 0.05 x 10(9)/l or higher (p less than 0.05). The general condition, Karnofsky score, body weight, number of CD4 positive cells and the lymphocyte stimulation in vitro improved during therapy, but the beneficial effects lasted only 6-9 months. Anaemia (Hb less than 6 mmol/l) developed in 21 (43%) of the patients. (Pan)cytopenia prompted dose reduction in 14 patients, in 5 patients with pancytopenia therapy was withdrawn. The length of stay in hospital was 885 days for the whole group of patients, equivalent to 20 days per patient year.     

Malnutrition in patients with AIDS

Malnutrition is a frequent problem in persons infected with the human immunodeficiency virus. The origin of malnutrition in patients with AIDS may be multifactorial. The primary mechanisms include disorders of food intake, alterations in intermediary metabolism, and nutrient malabsorption. Attention to the problems of malnutrition in patients with AIDS is of paramount importance because the timing of death in these patients may be more closely related to degree of body cell mass depletion than to any specific underlying infection. Nutritional support can improve nutritional status in selected patients, and repletion of body cell mass may be associated with functional improvement. Early assessment, attention to nutritional requirements, and prompt intervention can minimize wasting and replete body cell mass. This article examines the evidence for malnutrition in patients with AIDS, reviews the studies of nutritional support, and presents an approach to the management of malnutrition in AIDS.     

Survival of AIDS patients in Norway

The survival function of the 100 first AIDS patients in Norway is presented and analyzed with respect to four factors obtained at the time of diagnosis; a) year of diagnosis b) initial AIDS related disease c) knowledge of HIV seropositivity prior to onset of AIDS and d) age at time of diagnosis. The median survival was 9.3 months. Among the known seropositive AIDS patients there were almost twice as many with Pneumocystis carinii pneumonia as initial AIDS related disease, as among the not known seropositives (relative risk 1.8). With Cox regression analysis we found that known seropositivity and age are factors that appear to influence survival, whereas year of diagnosis and initial AIDS related disease apparently do not. The mechanism whereby prior knowledge of HIV seropositivity leads to apparent increase in survival may be due to better follow-up and thereby an earlier date of diagnosis.     

Stigmatization of AIDS patients by physicians.

A randomly selected sample of physicians in three large cities was asked to read one of four vignettes describing a patient. They then completed a set of objective attitude measures eliciting their reactions to the patient described in the vignette. The vignettes were identical except that the patient's illness was identified as either acquired immunodeficiency syndrome (AIDS) or leukemia and the patient's sexual preference as either heterosexual or homosexual. Harsh attitude judgements were associated with the AIDS portrayals, as well as much less willingness to interact even in routine conversation when the patient's illness was identified as AIDS. Increasing numbers of AIDS patients will be seeking medical attention from physicians in all areas of the country and it will be important for health care professions to develop programs which counter unreasonable stigma and prejudicial attitudes that may be associated with this illness.     

老年艾滋病患者58例临床分析

目的 探讨老年艾滋病患者的临床特点.方法 对58例年龄≥60岁的老年艾滋病患者的临床资料进行回顾性分析.结果 58例老年艾滋病患者中,男性48例(82.76％)、女性10例(17.24％).异性性传播52例(89.66％),1例有输血史,其余感染原因不明.临床表现以发热(34例)、咳嗽(32例)、乏力(31例)多见.CD4+T细胞计数7～ 437个/μL,平均CD4+T细胞计数149.6个/μL.并发机会性感染56例(96.56％),其中二重或多重感染41例(70.69％),呼吸系统感染最常见,共39例(67.24％),消化系统感染23例,血液系统感染5例.18例接受HAART 6个月,10例病毒载量＜400拷贝/mL,13例CD4+T细胞升高,平均147个/μL.住院期间死亡3例(5.17％).结论 老年HIV感染以异性性传播为主,可出现各种机会性感染,合并症复杂,二重或多重机会性感染多见,因此应充分重视对老年艾滋病的预防和治疗.HAART可有效抑制病毒的复制,使细胞免疫CD4+T细胞升高,改善患者的生活质量.