53例艾滋病患者机会性感染的治疗

目的:了解艾滋病(AIDS)患者机会性感染(OI)状况及治疗方法。方法:53例AIDS患者中44例出现机会性感染,共59例次,其中口腔真菌感染21例,结核杆菌感染7例,卡氏肺囊虫感染15例,一般细菌性肺炎5例,隐球菌脑膜炎4例,其它感染7例。口腔真菌感染者给予氟康唑100 mg,po,qd,疗程10~14 d;卡氏肺囊虫肺炎(PCP)及一般细菌性肺炎者给予抗细菌感染(第三代头孢菌素)加大剂量磺胺甲恶唑/甲氧苄啶(SMZ-TMP,4.5 g.d-1),疗程10~14 d;结核杆菌感染者按2HRZE/4HR方案治疗;隐球菌脑膜炎给予两性霉素B(疗程2~3月)加氟康唑(疗程3月)。小儿用量按体重计算。结果:44例机会性感染患者中,好转27例,未愈10例,死亡7例。结论:艾滋病患者机会性感染较为常见,治疗药物的选择有其特殊性;高效抗逆转录病毒治疗(HAART)对于机会性感染的治疗具有重要的影响。

Drug Treatment of Opportunistic Infections in 53 Patients with AIDS

Objective: To study the status and therapies for OIs of AIDS patients.Methods: In 53 AIDS cases,44 cases had opportunistic infections for 59 case-times.Patients with thrush(21 cases) were given 100 mg of fluconazole po,qd,for consecutive 10～14 d.Patients with pneumonia(20 cases,including PCP and general bacterial pneumonia) were treated with antibacterial drugs(cephalosporin of the third generation) in combination with sulfamethoxazole-trimethoprim(SMZ-TMP) in high doses(3.0 g·d~(-1)) for 10～14 d.Patients with tubercle Bacillus infection(7 cases) were treated with 2HRZE/4HR.The patient with cryptococcal meningitis(4 cases) was treated with amphotericin B for 2 weeks and fluconazole for 2 months.The dose for children was in accord ance with their weight.Results: In the 44 cases of OI treated,27 showed improvement,10 didn't obviously improve and 7 died.Conclusion: OI appears frequently among AIDS patients.The drug for OI is special.HARRT is important for the therapy of OI.