178例艾滋病皮肤表现的临床分析

Clinical Analysis of AIDS-Associated Skin Menifestation

目的:探讨艾滋病皮肤粘膜疾病的病种分布、临床表现特点。方法:回顾分析178例艾滋病患者住院期间皮肤粘膜疾病的种类、特征及实验室指标。结果:艾滋病皮肤粘膜损害复杂,以真菌、病毒感染为主,分别为165例(92.7%)、120例(67.4%),疾病种类依次为口腔念珠菌病、口腔毛状粘膜白斑、马内青霉病、带状疱疹等23种。有2种以上皮肤粘膜疾病者128例(71.9%)。91.6%的艾滋病患者皮肤粘膜疾病发生于CD4+T淋巴细胞小于200 cells/μL时,其中发生于小于50 cells/μL占74.7%。结论:艾滋病皮肤粘膜损害以真菌、病毒感染为主,皮损的镜检、真菌培养可作为艾滋病皮损常规检查之一,皮肤马内青霉感染是诊断艾滋病的重要线索,部分皮肤粘膜病变可作为诊断疾病进入艾滋病期的依据之一。

Objective：To explore the clinical features and locations of skin and mucosa lesions in AIDS patients. Methods ：To review and analyze the clinical features and laboratory findings of 178 AIDS patients in hospital. Results： Skin and mucosa lesions in AIDS patients were complex fungi and virus infections, there were 165 （92.7%） and 120 cases （67.4%） respectively, devolution of the 23 diseases were oral candidiasis, oral hairy leukoplakia, penicilliosis marneffei, herpes zoster et al. 128 cases have more than 2 diseases at the same time, 91.6% cases of all occurred skin lesions when the CD4^＋ lymphocyte counts less than 200 cells/uL and 74. 7% cases of all occurred when the CD4^ ＋ lymphocyte counts less than 50 cells/uL. Conclusion： The most of skin and mucosa lesions were fungi and virus infection in AIDS patients, microscope test of the smear from skin lesion and culture of the pathogenic fungi might be the regular clinical tests. Skin peni- cillium mameffei was important to diagnosis in AIDS, some skin and mucosa lesions could be one of the evidences to identify AIDS with other disease.