CAJ | 학술논문

目的：探讨我院HIV/AIDS患者住院的原因，机会性感染的疾病谱及机会性感染发生与CD4＋T淋巴细胞的关系。方法：收集2005年1月～2013年8月在我院住院的109例次HIV/AIDS病人，就其临床及实验室资料进行回顾性分析。结果：109例次HIV/AIDS住院患者，因服用抗病毒药物出现严重副反应而住院15例次；因机会性感染而住院83例次。机会性感染以消化系统和呼吸系统的疾病为主，前三位机会性感染为细菌性呼吸系统感染30例次、念珠菌感染28例次、结核菌感染15例次；机会性感染的发生和CD4＋T淋巴细胞计数有密切关系；细菌、念珠菌、结核菌在CD4＋T淋巴细胞的每个区段都可发生，但CD4 T淋巴细胞越低，念珠菌感染越高且重，有时波及胃、肠、皮肤和四肢，而结核菌感染则症状不典型，伴有全身或纵膈淋巴结肿大。 PCP仅在CD4＋T淋巴细胞＜200个/mm3发生。 CD4＋T淋巴细胞在350～500个/mm3之间有机会性感染出现。结论：机会性感染和抗病毒药物副反应是患者就医住院的主要原因；CD4＋T淋巴细胞＜500个/mm3即应启动抗病毒治疗。
목적：탐토아원HIV/AIDS환자주원적원인，궤회성감염적질병보급궤회성감염발생여CD4＋T림파세포적관계。방법：수집2005년1월～2013년8월재아원주원적109례차HIV/AIDS병인，취기림상급실험실자료진행회고성분석。결과：109례차HIV/AIDS주원환자，인복용항병독약물출현엄중부반응이주원15례차；인궤회성감염이주원83례차。궤회성감염이소화계통화호흡계통적질병위주，전삼위궤회성감염위세균성호흡계통감염30례차、념주균감염28례차、결핵균감염15례차；궤회성감염적발생화CD4＋T림파세포계수유밀절관계；세균、념주균、결핵균재CD4＋T림파세포적매개구단도가발생，단CD4 T림파세포월저，념주균감염월고차중，유시파급위、장、피부화사지，이결핵균감염칙증상불전형，반유전신혹종격림파결종대。 PCP부재CD4＋T림파세포＜200개/mm3발생。 CD4＋T림파세포재350～500개/mm3지간유궤회성감염출현。결론：궤회성감염화항병독약물부반응시환자취의주원적주요원인；CD4＋T림파세포＜500개/mm3즉응계동항병독치료。
Objective:To analyze the causes for HIV/AIDS patients required hospitalization and investigate the spectrum of disease in the opportunistic in-fection as well as the relationship between the opportunistic infection and CD4 +positive T-lymphocyte count.Methods:The clinical data and laboratory findings were retrospectively examined in 109 patients with HIV/AIDS infection undergone therapy on hospitalization basis in our hospital between January 2005 and August 2013.Results:Of the 109 patients,15 required hospitalization due to serious adverse effects from administration of antiviral drugs and 83 due to the opportunistic infections that were involved in diseases of either digestive or respiratory system ,including bacterial infection with the respiratory system(n=30),candidiasis(n=28) and infection of mycobacterium tuberculosis(n=15).The opportunistic infection was strongly related to CD4 +T-lymphocyte count,and the infection from bacterium,candida or mycobacterium tuberculosis had occurred regardless of CD4 +cell count.Yet,lower CD4 +T-lymphocytes led to severer infection from candida and more involvement of the stomach ,intestines,skin and limbs.The patients infected by mycobacteri-um tuberculosis were characterized by atypical symptoms and with enlargement of systemic or mediastinal lymph nodes .Pneumocystsis carinii pneumonia occurred at the count of CD4 +T-lymphocyte lower than 200 cells/mm3 ,and opportunistic infection at 350~500 cells/mm3 .Conclusion: Hospitalization requirement is generally associated with opportunistic infection and adverse effects from antiviral medication for patients with HIV /AIDS infection,and ad-ministration of the antiviral drugs is necessary and rational if CD4 +T-lymphocyte count is lower than 500 cells/mm3 .