人类免疫缺陷病毒感染患者167例眼部表现临床分析

Clinical ocular region manifestations of 167 cases with human immunodeficiency virus infection

目的 分析人类免疫缺陷病毒（HIV）感染患者眼部病变表现的特点,以便及时发现,尽早治疗,减轻视功能的损害.方法 对2006年11月至2008年11月在尼日尔共和国三家医院167例HIV感染患者眼部病变、病程、症状、体征及全身情况作回顾分析.结果 167例患者以眼部病变首诊33例（19.76％）；眼部病变表现为机会性感染和肉瘤形成.表现依次为视网膜炎86例（51.0％）,葡萄膜炎46例（28.0％）；带状疮疹32例（19.0％）；神经系统病变19例（11.0％）；Kaposi肉瘤15列（9.0％）.视力损害低于正常98例（其中重度双眼盲17例、轻度19例；轻度单眼盲34例）；≥0.3者69例.所有病例伴程度不等全身慢性消耗性症状,CD 4/CD 8比值下降146例,平均0.056（正常值1.75～2.10）.结论HIV感染40％～92.3％可发生眼部病变,视力损害与视网膜/葡萄膜损害关系较大.鉴于HIV感染患者增加现状,其表现于眼部早期症状体征,应引起眼科医师高度重视,及早发现病变,及时治疗,提高患者生存质量.

Objective To analyze the pathological characteristics of ocular region in patients with human immunodeficiency virus （HIV） infection in order to detect and treat early to reduce the damage of visual function. Methods Retrospective analyzed 167 cases of HIV infection of their ocular region pathology,course of disease,symptoms,signs and general condition in three hospitals from November 2006 to November 2008 in Republic of Niger.Results A total of 167 patients were included in this study.Among them,33 cases with eye lesions appeared first （19.76%）,ocular region pathology manifested as opportunistic infection and sarcoma formation,86 cases （51.0%） as amphiblestritis,46 cases as uveitis （28.0%）,32 cases as zona （19.0%）,19 cases as nerve system lesions （11.0%）,15 cases as Kaposi sarcoma （9.0%）.Impairment of vision below normal was seen in 98 cases （including 17 cases of severe bilateral blindness,mild in 19 cases,mild single-blind 34 cases）,normal 69 cases.All patients with symptoms of varying degrees all over consumptions,CD4/CD8 ratio decreased in 146 patients,averaged 0.056 （normal 1.75-2.10）. Conclusions HIV infection with eye lesions occurs in 40-92.3%.Impairment of vision is mainly caused by amphiblestritis and uveitis.In view of increasing HIV infection,ophthalmologist should pay more attention to its early ocular symptoms and sign and offer early treatment to improve the quality of life for patients.