重庆市228例首诊AIDS住院患者流行病学及临床特征分析

The epidemiological and clinical characteristics of 228 first diagnosed AIDS patients in Chongqing

目的通过对重庆市公共卫生医疗救治中心首诊艾滋病（acquired immunodeficiency syndrome，AIDS）患者的病例档案资料进行整理分析，探讨重庆市AIDS患者的流行病学及临床特征，为临床治疗和疾病控制的深入研究提供科学依据。方法检索重庆市公共卫生医疗救治中心（重庆市唯一一家收治AIDS的定点医院）1995年12月～2008年12月AIDS患者的病例档案，对AIDS首诊住院患者的病例档案进行归类整理，采用统计学方法对病例的年龄、性别、职业、传播途径和临床症状等分布特征进行描述。结果从1995年12月至2008年12月，重庆市公共卫生医疗救治中心首诊AIDS确诊患者共228例，其中1995年为1例，2008年为91例；病例以重庆市区及邻近的区县为主（占78．51％）；男女比例为2．30：1；30～50岁占72．81％，年龄最小为7个月，最大为92岁；异性性接触为主要传播途径（70．18％），其次为静脉吸毒（12．72％）；临床以机会感染症状为主要表现，其中结核分枝杆菌感染占60．53％（138／228），合并肺部细菌感染（包括葡萄球菌、链球菌、肺炎球菌等），占57．89％（132／228）；口腔白色念珠菌病，占46．93％（107／228）；临床检验中CD4淋巴细胞计数〈50个／μl 140例、50～200个／μl 70例、〉200个／μl 18例。结论重庆地区艾滋病疫情呈加速上升趋势，应当加大市区及邻近区县青壮年人群的AIDS控制力度，重视异性性传播的干预；患者第一次入院多因机会性感染就诊，临床医生必须提高对AIDS的警觉性。

Objective To study the distribution characteristics of fist diagnosed AIDS cases in Chongqing, and provide scientific basis for prevention and control strategy. Methods Clinical data of 228 patients of first diagnosed AIDS cases who were hospitalized in Public Health Center for Medical Treatment （the only one hospital be recommended by government to treat AIDS patients in Chongqing） were collected and reviewed retrospectively between December 1995 and December 2008. The statistically methods have been used to describe the characteristics of personal, route of transmission and clinical symptoms. Results From December 1995 to December 2008, the total first diagnosed AIDS cases in Public Health Center for Medical Treatment were 228. 1 case and 91 cases had been diagnosed in 1995 and 2008 respectively. The majority of them （78.51% ） were come from the areas of urban field and nearby regions. The male to female ratio was 2.30 ： 1. The age group of 30 - 50 （72.81% ） outnumbered other groups. The youngest one was 7 month old, and the oldest one was 92 years old. The heterosexual contact was the major route of transmission （70.18 % ） and the symptoms of opportunistic infection were the major clinical appearances. Conclusions In Chongqing area, the epidemic situation of AIDS present the accelerating upward trend. The measures of AIDS/HIV control should be increased among the population of urban young adults and the neighboring counties. The intervention methods should focus on the heterosexual transmission. The symptoms of opportunistic infections were the most reasons of AIDS patients came to hospital for first treatment. So, the clinicians must increase AIDS/ HIV awareness.