CAJ | 학술논문

目的：了解H IV感染者／艾滋病患者在三级甲等综合性医院的实验室诊断及临床特征。方法回顾分析2007～2013年重庆市急救医疗中心就诊的 HIV感染者／艾滋病患者的实验室诊断及其临床特征资料。结果7年共进行 HIV抗体筛查47355例，HIV抗体初筛阳性179例，确认阳性171例。在5例HIV抗体结果不确定者中，随访2例，1例排除HIV感染，1例转为HIV抗体阳性。HIV感染者常与乙型肝炎病毒（HBV）、丙型肝炎病毒（HCV）及梅毒螺旋体（TP）等合并二重或多重感染。HIV感染者年龄18～86岁，其中60岁以上年龄段占9．36％。多数患者就诊时具有2种及其以上临床表现。结论 HIV抗体筛查试验存在假阳性结果，HIV抗体阳性结果报告必须以Western blot确证试验结果为准。对HIV抗体不确定结果需定期随访或结合其他检测方法、流行病学资料等判断。对HBV、HCV及T P感染者应进行常规HIV抗体筛查。不应忽略对老年患者人群的诊断。艾滋病临床表现特异性不强，需重视与其他病因引起的类似症状的疾病相鉴别，以减少漏诊、误诊。
목적：료해H IV감염자／애자병환자재삼급갑등종합성의원적실험실진단급림상특정。방법회고분석2007～2013년중경시급구의료중심취진적 HIV감염자／애자병환자적실험실진단급기림상특정자료。결과7년공진행 HIV항체사사47355례，HIV항체초사양성179례，학인양성171례。재5례HIV항체결과불학정자중，수방2례，1례배제HIV감염，1례전위HIV항체양성。HIV감염자상여을형간염병독（HBV）、병형간염병독（HCV）급매독라선체（TP）등합병이중혹다중감염。HIV감염자년령18～86세，기중60세이상년령단점9．36％。다수환자취진시구유2충급기이상림상표현。결론 HIV항체사사시험존재가양성결과，HIV항체양성결과보고필수이Western blot학증시험결과위준。대HIV항체불학정결과수정기수방혹결합기타검측방법、류행병학자료등판단。대HBV、HCV급T P감염자응진행상규HIV항체사사。불응홀략대노년환자인군적진단。애자병림상표현특이성불강，수중시여기타병인인기적유사증상적질병상감별，이감소루진、오진。
Objective To understand laboratory diagnosis and clinical characteristics of human immunodeficiency virus (HIV ) infection and AIDS patients in three comprehensive hospitals .Methods Laboratory diagnosis and clinical characteristics dates of people living with HIV/AIDS patients consulted in Chongqing Emergency Medical Center between 2007 to 2013 were retrospective‐ly analyzed .Results Totally 47 355 cases were carried HIV antibody screening during 7 years ,179 cases of HIV antibody were positive in preliminary screening ,171 cases were confirmed as positive .Among 5 cases of HIV antibodies result unconfirmed ,2 ca‐ses were followed up ,1 case was ruled out HIV infection ,1 case was converted to HIV antibody positive .People living with HIV al‐ways merging double or multiple infection with hepatitis b virus (HBV) ,hepatitis c virus (HCV) and treponema pallidum (TP) and so on .People living with HIV aged from 18 to 86 years old ,9 .36% was over 60 years old .Most patient has two or more clinical manifestations when consulted a doctor .Conclusion There were false‐positive of HIV antibody preliminary screening ,HIV anti‐body positive results must be confirmed by Western blot confirmatory test .Uncertainty of HIV antibody results should be judged by regularly follow‐up or combining with other detection methods ,epidemiological data .Routine HIV antibody screening should be adopt for HBV ,HCV and TP infection .Elder patients should not be ignored .Clinical specificity of HIV/AIDS is not strong ,it is need to be valued and identified from other cause similar symptoms of diseases caused by phase identification ,in order to reduce missed diagnosis and misdiagnosis .