CAJ | 학술논문

目的：探讨以神经系统症状首发的获得性免疫缺陷综合征( acquired immune deficiency syndrome, AIDS)的发病机制、误诊原因及防范措施。方法回顾性分析我院2007年1月—2013年12月误诊的以神经系统症状首发的AIDS 7例的临床资料。结果本组6例以头痛、头晕就诊,伴记忆力减退2例,伴腹胀、厌食1例；1例以左上肢麻木就诊。均否认毒品接触史、冶游史及输血史。7例首诊考虑后循环缺血5例,躯体化障碍和脑梗死各1例,给予相应治疗,症状均无缓解,进一步行人类免疫缺陷病毒( human immunodeficiency virus, HIV)抗体定量检查及蛋白印迹确认试验阳性,确诊AIDS,转疾病预防控制中心治疗。结论以神经系统症状首发的AIDS易误诊。耐心细致病史询问、发散诊断思维和及时进行特异性医技检查可减少或避免其误诊误治。
목적：탐토이신경계통증상수발적획득성면역결함종합정( acquired immune deficiency syndrome, AIDS)적발병궤제、오진원인급방범조시。방법회고성분석아원2007년1월—2013년12월오진적이신경계통증상수발적AIDS 7례적림상자료。결과본조6례이두통、두훈취진,반기억력감퇴2례,반복창、염식1례；1례이좌상지마목취진。균부인독품접촉사、야유사급수혈사。7례수진고필후순배결혈5례,구체화장애화뇌경사각1례,급여상응치료,증상균무완해,진일보행인류면역결함병독( human immunodeficiency virus, HIV)항체정량검사급단백인적학인시험양성,학진AIDS,전질병예방공제중심치료。결론이신경계통증상수발적AIDS역오진。내심세치병사순문、발산진단사유화급시진행특이성의기검사가감소혹피면기오진오치。
Objective To investigate the first symptom of AIDS in nervous system, and analyze the misdiagnosis cause, and enhance awareness of AIDS. Methods Retrospective analysis of 7 misdiagnosed acquired immune deficiency syndrome ( AIDs) cases with neurological symptoms at onset admitted to our hospital during January 2007 and December 2013 was made. Results There were cases of headaches and dizziness in 6 patients, with memory disorder in 2 patients, with abdominal disten-sion anorexia in 1 patient;Body lack of power in 1 patient. All the patients denied drug exposure history, amusement history and blood transfusion history. In the 7 cases, 5 cases were misdiagnosed as posterior circulation ischemia, 1 case was misdiagnosed as somatization disorder, and 1 case of left upper limb weakness patient was misdiagnosed as cerebral infarction. After corre-sponding treatment there was no sings of relief in symptoms. HIV antibody test result was positive, and validation test later con-firmed AIDS, and then the patients were transferred to the center for disease control and prevention for treatment. Conclusion AIDS patients with a manifestation of neurological symptoms as the first symptom tend to be misdiagnosed. An inquiry of detailed medical history, creative thinking and special medical examination may help to reduce misdiagnosis and mistreatment rates.