CAJ | 학술논문

目的：探讨获得性免疫缺陷综合征患者高效抗逆转录病毒治疗（HARRT）后，巨细胞病毒性视网膜炎（CMVR）相关免疫重建炎性综合征的临床特点。方法分析首都医科大学附属北京地坛医院2010年9月至2012年1月收治的130例获得性免疫缺陷综合征患者HAART前后的临床特点，在抗病毒治疗过程中出现的CMVR相关免疫重建综合征在眼部的表现及治疗转归，并进行观察分析。结果130例接受HAART的获得性免疫缺陷综合征患者中，出现眼部CMVR相关免疫重建综合征8例；HARRT治疗前的CD4为（17±11）个/μl，平均出现CMVR的时间为36 d，未中断HARRT治疗，加用病毒治疗，病情得到有效的控制。结论 HAART可使免疫重建，会启动一些接受抗病毒治疗获得性免疫缺陷综合征患者的炎症反应，在HARRT治疗前后一定要密切眼科检查，及时诊治，提高HIV/AIDS患者的生存质量。
목적：탐토획득성면역결함종합정환자고효항역전록병독치료（HARRT）후，거세포병독성시망막염（CMVR）상관면역중건염성종합정적림상특점。방법분석수도의과대학부속북경지단의원2010년9월지2012년1월수치적130례획득성면역결함종합정환자HAART전후적림상특점，재항병독치료과정중출현적CMVR상관면역중건종합정재안부적표현급치료전귀，병진행관찰분석。결과130례접수HAART적획득성면역결함종합정환자중，출현안부CMVR상관면역중건종합정8례；HARRT치료전적CD4위（17±11）개/μl，평균출현CMVR적시간위36 d，미중단HARRT치료，가용병독치료，병정득도유효적공제。결론 HAART가사면역중건，회계동일사접수항병독치료획득성면역결함종합정환자적염증반응，재HARRT치료전후일정요밀절안과검사，급시진치，제고HIV/AIDS환자적생존질량。
Objectlve To summarize the clinical manifestations of IRIS (immune reconstruction inflammatory syndrome) in eye related to cytomegalovirus retinitis (CMVR) during highly active antiretroviraltherapy (HAART).Methods From September 2010 to January 2012, a prospective cohort of 130 acquired immunedeifcienc syndrome (AIDS) patients with HAART from Beijng Ditan Hospital, Capital Medical University, were recruited for a follow up of 12 weeks. The data of general information, clinical manifestations, treatment and prognosis in eye diseases related to CMVR were collected, respectively. Blood samples were collected at pre HAART and post IRIS for CD4+Tcell count examinations. A statistical analysis was performed.Results There were 8 (6%) case of eye diseases related to CMVR immune reconstitution inflammatory syndrome (IRIS) were found. The median onset of eye diseases related to CMV IRIS was 36 days. There was a signiifcant increase of CD4+T cell count after IRIS. The disease had been effectively controlled with anti-CMV treatment, eventhough with no interruption of HAART. However, visual acuity decreased with signiifcant differences. Conclusions Effective HARRT may restore immune responses in patients, while at the same time it might as well cause inlfammatory reactions in eyes. Thus, it is important to pay much attention to ophthalmic examinations throughout the whole time of HARRT for improving the life quality of HIV/AIDS patient.