表现为慢性腹泻的儿童艾滋病7例

Analysis of Acquired Immunodeficiency Syndrome with Manifestation of Chronic Diarrhea in 7 Children

目的探讨以慢性腹泻为主要表现的儿童获得性免疫缺陷综合征（艾滋病,AIDS）的临床特点,分析其原因。方法1999年1月-2006年12月北京儿童医院共确诊AIDS儿童17例,其中表现为慢性腹泻患儿7例。男4例,女3例。对其腹泻时间、腹泻程度、大便特点、伴随症状及各项实验室检查结果等临床资料进行回顾性分析。结果发病年龄2-9岁,平均6岁。腹泻时间1-16个月,平均6个月。以慢性腹泻就诊4例,以发热、咳嗽、消瘦就诊3例。腹泻出现时间：病程开始即出现6例,仅1例是病程第9个月出现。7例均有营养不良,其中2例为中度,5例为重度;7例患儿均有贫血,其中轻度4例,中度3例;6例体质量、身高分别位于同年龄同性别正常儿童的第3百分位以下。大便常规：阴性5例,阳性2例（白细胞2-15/HP,红细胞0-60/HP）;7例大便涂片均未见寄生虫虫卵、滋养体及真菌孢子;大便普通培养：3例多次培养均阴性;大便真菌培养：2例阴性,1例培养出白色念珠菌（2次）。检测CD系列的全部患儿CD4均明显降低,CD4/CD8降低5例。伴低钾血症及代谢性酸中毒5例;发热4例。结论儿童AIDS中的腹泻症状较常见,病程相对较长,且多伴生长发育迟缓、营养不良及贫血,与机会性感染及人类免疫缺陷病毒感染相关。

Objective To explore the clinical manifestation and laboratory examination of chronic diarrhea in children with acquired immunodeficiency syndrome （AIDS） and analyze the reasons that causes the chronic diarrhea in children. Methods Clinical data of 7 patients （male 4 cases,famale 3 cases）with AIDS with manifestation of chronic diarrhea among the 17 cases were diagnosed as AIDS in Beijing children＇s hospital from Jan. 1999 to Dec. 2006. The time of diarrhea, degree of dinrrhea, characteristic of stool, accompaniment symptom, laboratory examination were retrospectively analyzed. Results The average onset age was 6 years old （ from 2 - 9 years old）. The average time of diarrhea was 6 months （from 1 - 16 months）. Four cases main complained with chronic diarrhea ,3 cases came to the hospital because of fever, cough and wasting ;6 cases with diarrhea,7 cases with malnutrition and anemia ,5 cases accompanied hypokalemia and metabolic acidosis,6 cases had delay in growth and development,2 cases with abnormal stool routine exam, 1 case with positive stool culture of fungi. All patients were with lower CD4,5 cases with lower CD4/CD8. Conclusions Chronic diarrhea is a common symptom in children with AIDS, and usually accompanied by obvious delay in growth and development, malnutrition and anemia, the reasons that causes the chronic diarrhea are considered to be related with both the opportunistic infection and HIV infection.