HIV/AIDS伴发神经系统病变60例临床分析 |
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引用本文: | 李仕雄,胡海军,李威,郭彩萍,张彤,吴昊,代丽丽.HIV/AIDS伴发神经系统病变60例临床分析[J].北京医学,2012,34(3):181-184. |
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作者姓名: | 李仕雄 胡海军 李威 郭彩萍 张彤 吴昊 代丽丽 |
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作者单位: | 广西省贵港市人民医院感染科 537100;河南省安阳市第五人民医院;首都医科大学附属北京佑安医院感染科 |
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基金项目: | 国家自然科学基金(30872226);北京市科技计划(D09050703590901) |
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摘 要: | 目的总结HIV/AIDS住院患者中伴发神经系统病变的发病率、疾病谱及临床特点。方法对2009-2011年在北京佑安医院住院治疗的HIV/AIDS伴发神经系统病变患者的临床资料进行回顾性分析,总结临床表现、诊治情况及预后。结果 620例HIV/AIDS住院患者中,伴发神经系统病变者60例(9.7%)。主要临床表现包括头痛46例(76.7%)、发热43例(71.7%)、呕吐28例(46.7%)、肢体活动障碍23例(38.3%)、脑膜刺激征20例(33.3%)、意识障碍18例(30.0%)等。一般神经系统病变主要包括脑梗死5例(8.3%),多发性神经根炎5例(8.3%),不明原因的中枢神经系统感染7例(11.7%);AIDS中枢神经系统指征性疾病40例,主要包括隐球菌性脑膜炎16例(26.7%),弓形体脑病10例(16.7%),结核性脑膜炎5例(8.3%)等。一般神经系统病变患者的病死率为0.0%,40例中枢神经系统指征性疾病患者的病死率为10.0%(4/40),8例不明原因中枢神经系统感染和占位的患者的病死率为50.0%(4/8)。结论 HIV/AIDS患者合并各种神经系统并发症比较多见,主要症状包括头痛、发热、呕吐等。在各种中枢神经系统指征性疾病中,以隐球菌性脑膜炎和弓形体脑病的发病率最高;早期诊断可以降低病死率。
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关 键 词: | 艾滋病 神经系统合并症 机会性感染 |
Clinical analysis on 60 cases of HIV/AIDS with nervous system complications |
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Institution: | LI Shi-xiong, HU Hai-jun, LI Wei, et al (Department of Infectious diseases, Guigang City People’s Hospital, Guangxi 537100) |
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Abstract: | Objective To analyze the incidence, disease spectrum and clinical characteristics of neurological disorders among hospitalized HIV/AIDS patients. Methods Retrospectively analyzed the clinical presentation, diagnosis, management and prognosis of HIV/AIDS inpatients complicated with neurological disorders in Beijing You’an Hospital from 2009-2011. Results Neurological complications were observed in 60 patients(9.7%) out of 620 HIV/AIDS inpatients. Main symptoms included headache(76.7%), fever(71.7%), vomiting(46.7%), movement disorder of limbs(38.3%), positive meningeal irritation signs(33.3%) and disturbance of consciousness(30.0%). Common diseases of neurological system included 5 cases(8.3%) of cerebral infarction, 5 cases(8.3%) of peripheral neurological disorder, 7 (11.7%) central neurological system infections of unknown origin. 40 cases(66.7%) of indicative central nervous system diseases of AIDS, mainly included 16 cases(26.7%) of cryptococcal meningitis, 10 cases(16.7%) of cerebral toxoplasmosis, 5 cases(8.3%) of tuberculosis meningitis. No one died in common diseases of neurological system, 10.0% died in indicative central nervous system diseases, and 4 died in 8 patients with unclear diagnoses. Conclusions It is common to see neurological complications among HIV/AIDS patients,which are difficult to diagnose and treat, and with a high death rate. |
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Keywords: | Acquired immunodeficiency syndrome(AIDS) Nervous system complication Opportunistic infection |
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