艾滋病合并侵袭性真菌感染35例临床分析

Clinical analysis of 35 cases of AIDS with invasive fungal infection

目的分析艾滋病(AIDS)合并侵袭性真菌感染的发生情况及临床特点,为其诊治提供参考。方法回顾性分析85例AIDS患者的临床资料,总结侵袭性真菌感染的发病情况及临床特点。结果85例AIDS患者继发侵袭性真菌感染35例,感染率为41．2％,感染部位以消化道为主,占44．4％,致病菌以白念珠菌(白假丝酵母)为主,占57．4％,侵袭性真菌感染病例主要发生于CD4^+T淋巴细胞计数＜100个/μl的患者,占71．8％。35例患者中27例治愈,8例死亡。结论侵袭性真菌感染是AIDS患者主要的机会性感染之一,其发生与CD4^+T淋巴细胞计数密切相关,临床上以消化道真菌感染多见,侵袭性真菌感染的病死率高。

Objective To understand the clinical features of AIDS patients with invasive fungal infection and provide guidance for future diagnosis and treatment. Methods Eighty-five AIDS cases were retrospectively analyzed to summarize the clinical features, epidemiology, diagnosis and treatment of AIDS with invasive fungal infection. Results Of 85 AIDS eases, 35 （141.2%） had complications of invasive filngal infection. The major site of infection is alimentary tract （44.4%） ; the most frequently isolated fungus was Candida albicans （57.4%） ; 71.8% of the invasive fungal infections occurred in patients whose CD^4＋ T lymphocyte counts were 〈 100/μl. Infection was under control for 27 patients while the other 8 died subsequently. Conclusion Invasive fungal infection was one of the major opportunistic infections in AIDS patients; the occurrence of invasive fungal infection was associated with patients＇ low CD4^＋ T lymphocyte counts; most invasive fungal infections occured in alimentary tract; the mortality was still high although many new antifungal drugs are available.