儿童获得性免疫缺陷综合征临床特点

Clinical Feature of Children with Acquired Immunodeficiency Syndrome

目的探讨儿童获得性免疫缺陷综合征(AIDS)的病因、临床特征、诊治经过及预后,以提高对该病的认识。方法对2001年以来在广西医科大学第一附属医院儿科住院的12例儿童AIDS或疑似AIDS的临床及实验室检查资料进行回顾性分析,以总结其临床特点。结果12例患儿中男9例,女3例;年龄45d^9岁;11例患儿父母血清均为人类免疫缺陷病毒(HIV)抗体阳性或疑似因AIDS死亡者;临床表现为生长发育迟缓并不同程度营养不良12例(100%),长期不规则发热、间断性咳嗽及肝脾大各10例(83.3%),迁延性腹泻及淋巴结大各8例(66.7%),全身性皮炎6例(50%),大脑发育不全4例(33.6%),口腔念珠菌感染3例(26.7%),中耳炎2例(16.7%);实验室检查:12例2次血清HIV抗体检测均呈阳性,CD4+T淋巴细胞的百分比均下降,CD4+/CD8+细胞比值均降低,肝功能检查转氨酶均升高,3例血清巨细胞病毒抗体阳性,4例血培养及1例骨髓培养出马尔尼菲青真菌,大便涂片及培养4例找到真菌。死亡1例,余病例对症治疗效果差。结论儿童AIDS潜伏期相对较短,临床表现多样化,细胞免疫功能低下,对症治疗效果差。提高对该病的认识,可早期诊断、早治疗,延长患儿生命。

Objective To explore the causes,clinical feature,diagnoses and prognosis of children with acquired immunodeficiency syndrome （AIDS） and improve our awareness of this disease. Methods The clinical and laboratory data of 12 children with AIDS were analyszed retrospectively and the clinical feature was summed up. Results Among 12 children with AIDS,9 cases were boys and 3 cases were girls, aged from 45 days to 9 years old. The parents of 11 cases were positive in serological human immunodeficiency virus （HIV） antibody or died of AIDS. The main manifestations were developmental delay and various degree eacotrophia（ 12 case, 100% ） ,the others included abnormity fever, discontinuity cough and hepatosplenomegaly（ 10 eases,83.3 % ） , recurrent diarrhea and lymphadenopathy （8 cases,66.7% ） , skin lesion（6 cases,50% ） ,cerebral hypoplasia （4 cases,33.6% ） ,oral candidiasis（3 cases,26.7% ） ,and tympanitis（2 cases,16.7% ）. Laboratory tests showed ：all of 12 cases were positive in serological HIV antibody by test for 2 times. The percent of CD4^ ＋ and the ratio of CD4^ ＋ to CD8^ ＋ were decreasing. One ease was dead and the others had bad effect with allopathy. Conclusions Children with AIDS have short clinical latency,diversified clinical manifestation,low cell - mediated immunity function and bad effect with allopathy. To improve our awareness of the di-sease should be helpful for diagnosing and treating it early and prolonging the patients＇ life.