143例首诊发现的中国艾滋病患者临床特征分析

目的分析人类免疫缺陷病毒(HIV)感染及获得性免疫缺陷综合征(AIDS)患者的临床特征,提高HIV/AIDS患者的早期诊断水平。方法回顾性分析了1988年1月～2006年4月在我院首诊发现并有完整病史资料的143例HIV/AIDS患者的临床资料。结果143例患者中,57例无临床症状,经常规检查发现;86例有临床症状,全身症状中发热50例、消瘦18例,系统症状中呼吸系统34例、皮肤黏膜17例、消化系统16例。合并的常见机会感染包括卡氏肺孢子菌肺炎(PCP)27例(34.2%),口腔念珠菌感染16例(20.2%),结核感染15例(19.0%),巨细胞病毒(CMV)感染9例(11.4%)。所有患者多种机会感染均发生在CD4 T淋巴细胞计数小于200/mm3时,而合并CMV感染及隐球菌脑膜炎时该计数多小于100/mm3。血浆病毒载量与CD4 T淋巴细胞计数呈负相关(r=-0.420,P=0.001)。结论HIV/AIDS患者全身症状以发热、气短、消瘦最为明显。机会感染多侵及呼吸系统、皮肤黏膜、消化系统,并以PCP最常见。真菌是引起机会感染最多的病原。机会感染的发生与CD4 T淋巴细胞计数有一定相关性。

Clinical characteristics of 143 Chinese HIV/AIDS patients

Objective To investigate the clinical characteristics of human immunodeficiency virus(HIV)/acquired immunodeficiency syndrome(AIDS)patients in China.Methods Totally 143 HIV/AIDS patients who were first diagnosed in Peking Union Medical College Hospital form January 1988 to April 2006 were enrolled in this study.Clinical characteristics were retrospectively analyzed.Results Among 143 HIV/AIDS patients,57 patients had no clinical symptoms and were confirmed by routine examinations;86 patients had clinical symptoms,including fever(n=50),weight loss(n=18),and discomforts involving respiratory system(n=34),gastrointestinal system(n=16),and derma and mucosa(n=17).Oppotunistic infections(OIs)such as pneumocystis jiroveci pneumonia(PCP)(n=27),oropharyngeal candidiasis(n=16),tuberculosis(n=15),and cytomegalovirus(CMV)infection(n=9)were also observed in patients whose CD4 T cell counts were less than 200/mm 3.Most CMV infection and cryptococcal meningitis occurred in patients whose CD4 T cell counts were less than 100/mm 3.CD4 T cell count was negatively correlated with plasma viral load(r=-0.420,P=0.001).Conclusions Fever,dyspnea,and weight loss are the most common symptoms in the patients of this study.The respiratory system,gastrointestinal system,derma and mucosa are the most commonly affected areas by OIs,and PCP is the most common OI.The occurrence of OIs corelates with CD4 T cell count.