艾滋病肺部合并症六例分析

Study of 6 cases of AIDS with Pulmonary complication

目的 提高对艾滋病肺合并症的认识。方法 对１９９２ 年３ 月～１９９７ 年８ 月间诊断的６例艾滋病患者进行分析。结果 并发卡氏肺囊虫性肺炎（ Ｐ Ｃ Ｐ）５ 例（ 其中１ 例为艾滋病首发表现） ，其临床表现为发热（５／５） ，呼吸困难（４／５） 和低氧血症（５／５） ，平均动脉血氧分压为５８ ｍｍ Ｈｇ（１ ｍｍ Ｈｇ ＝０１３３ ｋ Ｐａ ） ，胸部 Ｘ 片显示，两肺弥漫间质或肺泡性浸润。另有支气管真菌感染、肺结核和淋巴结结核各１ 例（ 痰抗酸杆菌阳性、结核菌素试验阴性） 。结论 艾滋病容易发生各种肺合并症，尤以 Ｐ Ｃ Ｐ多见。对既往身体健康的青壮年，如突然发生肺炎和呼吸衰竭应警惕 Ｐ Ｃ Ｐ 发生。对特定情况下发生的肺机会性感染应警惕艾滋病，并及时检查血抗人类免疫缺陷病毒（ Ｈ Ｉ Ｖ） 抗体。

Objective To improve and to increase the awareness of pulmonary complications of AIDS Methods Six cases of confirmed AIDS from may 1992 to August 1997 were analyzed Results Of the six cases, there were five complicated with pneumocysitis carinii pneumonia (PCP) (in which one had PCP as the first occurred manifestation)。The clinical presentations of PCP were fever(5/5), dyspnea on exertion or at rest(4/5), and hypoxemi with mean PaO 2 of 58 1 mm Hg Chest X ray showed bilateral diffuse interstitial or alveolar infiltrates Pulmonary tuberculosis, tuberculous lymphadenities (fast acid staining positive but PPD negative ) and bronchial fungal infection were found in three cases Conclusions AIDS patients are at high risk of suffering from pulmonary complications, of which PCP is more common If young pateints who were healthy in the past suddenly suffered from pneumonia and respiratory failure , PCP should be considered When opportunistic pulmonary infections are diagnosed under special circumstances, one should be alert to the possibility of AIDS In these cases serum HIV antibodies should be checked immediately