艾滋病患者巨细胞病毒性视网膜炎的临床观察

Clinic Observation on Cytomegaloviral Retinitis in AIDS Patients

目的:探讨艾滋病患者巨细胞病毒(CMV)性视网膜炎发病影响因素、临床特点。方法:对艾滋病患者合并巨细胞病毒性视网膜炎7例(13眼)患者进行回顾性临床分析。结果:7例(13眼)患者都有不同程度视力下降,眼底镜检查具有特征性视网膜微血管病变,其中5例CMV IgM阳性,2例定量血CMV PCR检测为阳性,2例定量尿CMV PCR检测为阳性。经过高效抗逆转录病毒治疗、更昔洛韦治疗和免疫调节治疗后视力好转,CD4+T细胞计数大于100个/μl。结论:CMV性视网膜炎是AIDS严重的机会性感染,是造成视力丧失的主要原因,通过眼科检查早期发现,及时抗巨细胞病毒治疗,有利于控制病情,而高效抗逆转录病毒治疗对CMV性视网膜炎的预后产生重要意义。

Objective： To investigate the clinical features of cytomegaloviral retinitis（CMVR） in AIDS patients.Methods： The clinical data of 7 cases of CMVR with AIDS（13 infected eyes） were analyzed retrospectively.Results： Visual acuity was damaged to varying degrees.Characteristic retina microangiopathy was found by funduscopy examination.Five cases were detected positively by CMV-IgM antibody test,2 cases were positive in blood CMV-PCR,and 2 cases were positive in urine CMV-PCR.After highly active antiretroviral,ganciclovir and immunoregulation therapy,the vision acuity of the patients were improved and patients with CD4＋T lymphocyte counts increased by an average greater than 100 cell/μl.Conclusion： Cytomegaloviral retinitis was a kind of serious opportunistic infection in AIDS,and it was the primary cause of visual loss.Early diagnosis and antiviral therapy may control infection.Highly active antiretroviral therapy is useful for the prognosis of CMVR.