云南地区50岁及以上HIV感染者口腔损害流行情况分析

An epidemiological investigation of oral lesions in HIV infected subjects aged 50 years and older in Yunnan China

目的:了解云南地区50岁及以上中老年HIV感染者口腔损害发病特征。方法:对2013-01～2016-12到昆明市第三人民医院感染一科就诊的315名50岁及以上HIV感染患者进行了口腔黏膜损害发病情况的横断面调查,并分析了该口腔损害与CD4计数水平的关系。结果:在185例(58. 73%)中共检出13种口腔黏膜损害,检出率最高的是念珠菌病122例(38. 73%),其中伪膜型68例(21. 59%)、红斑型52例(16. 51%)、口角炎18例(5. 71%);次位为毛状白斑25例(7. 94%),以后依次为复发性口腔溃疡20例(6. 35%)、沟纹舌17例(5. 40%)、单纯疱疹11例(3. 49%),41例(13. 02%)和1例(0. 32%)患者分别同时检出2种及3种病损。2种以上损害同时检出频率及口腔念珠菌病检出率与CD4计数水平有关。结论:老年HIV感染者口腔黏膜损害十分常见,以口腔念珠菌病为主。

Objective: To investigate the characteristics of oral lesions in HIV infected patients aged 50 years or older in Yunnan.Methods: 315 HIV infected patients aged 50 years and older from January 2013 to December 2016 were included in a cross-sectional survey at the Third People’s Hospital of Kunming. The characteristics of oral mucosal lesions and the relationship between the oral lesions and CD4 count level were analyzed. Results: 13 kinds of oral mucosal lesion in 185 out of the 315 cases( 58. 73%) were observed. 122 cases were with candidiasis( 38. 73%),including 68( 21. 59%) of pseudomembranous type,52( 16. 51%) of erythema and 18( 5. 71%) of stomatitis;25( 7. 94%) were with Hairy leukoplakia,20( 6. 35%) with recurrent oral ulcer,17( 5. 40%) with fissured tongue,11( 3. 49%) with herpes simplex. 2 and 3 lesions were detected in 41 cases( 13. 02%) and 1 case( 0. 32%),respectively. The rate of simultaneous detection of more than 2 lesions and the detection rate of oral candidiasis were related to the CD4 count level. Conclusion: Oral mucosal lesions are common in elderly patients with HIV infection,and oral candidiasis is the main type.