18例确诊和疑诊儿童艾滋病的临床分析

Analysis of clinical features of 18 diagnosed or suspected AIDS children

目的:分析比较确诊和疑诊儿童艾滋病(Acquired immunodeficiency syndrome,AIDS)患者的临床特征。方法:对2006年4月～2009年9月收治8例确诊AIDS患者和10例疑诊AIDS患者的临床资料进行分析比较。结果:两组患者临床症状多出现在婴幼儿阶段;大多数来自农村,其父母相关病史对儿童AIDS诊断有重要意义;临床表现多样,血液系统受累最常见;一般感染没有特异性,主要为呼吸、消化系统等反复感染;淋巴细胞分类CD4+细胞降低,CD4+:CD8+细胞比值降低;部分患者表现先天性畸形。2组不同的是,疑诊组病情较确诊组严重;确诊组绝大多数为母婴传播,其次输血传播,疑诊组均为母婴传播。结论:儿童AIDS临床表现多样,没有特异性,常因同一症状或疾病反复就诊,有血液系统表现者,病情常较重。临床考虑AIDS者,做HIV抗体和淋巴细胞分类检查有助于诊断。

Objective：To analyze and compare the clinical features of children diagnosed with acquired immunodeficiency syndrome（AIDS）or suspected of being infected with the disease.Methods：The clinical history of 8 cases of children diagnosed with AIDS and 10 cases of children suspected of being infected with the disease from April,2006～September,2009 was analyzed and compared.Results：In both groups,clinical symptoms of most patients appeared in infancy period.Most of the patients came from the rural area,and their parents＇ medical history was very important for the diagnosis of AIDS in the children.The clinical manifestation was varied,but the most common one was blood disease;infection was nonspecific and mainly repeated respiratory or digestive system infection;the counts of CD4＋ lymphocyte and the ratio of CD4＋ to CD8＋ lymphocyte were decreased;some of the patients were registered as congenital malformation.The difference between the two groups was that the group suspected of being infected with AIDS was more serious than the diagnosed group.The most cases of the diagnosed AIDS in children were mother-to-child transmission,followed by that of blood transmission,but all cases of the suspected patients were mother-to-child transmission.Conclusion：The clinical manifestations of AIDS in children are varied and nonspecific;it often needs repeated medical visits because of the same symptom or disease.Patients with hematological manifestations are often more serious than others.Clinically,children who are suspected of AIDS should get examination of antibody to HIV,and lymphocyte count and classification.